Table 3 Comparison of PASS and GAPP scores following index and recurrent surgery
PASS feature | Points | Index surgery | Recurrent surgery |
Vascular invasion | 1 | No | No |
Capsular invasion | 1 | Yes | No |
Invasion into periadrenal adipose tissue | 1 | No | Yes |
Large nests or diffuse growth | 2 | Yes | No |
Focal or confluent necrosis | 2 | No | No |
High cellularity | 2 | No | No |
Tumor cell spindling | 2 | No | No |
Cellular monotony | 2 | No | No |
Increased mitotic figures > 3/10 high power fields | 2 | No | No |
Atypical mitotic figures | 2 | No | No |
Profound nuclear pleomorphism | 1 | No | No |
Hyperchromasia | 1 | No | No |
Total score | 19 | 3 | 1 |
GAPP feature | Points scored | Index surgery | Recurrent surgery |
Histological pattern | |||
Zellballen | 0 | No | Yes |
Large and irregular cell nest | 1 | No | Yes |
Pseudorosette | 1 | No | No |
Cellularity | |||
Low (< 150cells/HPF) | 0 | Yes | Yes |
Moderate (150–250 cells/HPF) | 1 | No | No |
High (> 250 cells/HPF) | 2 | No | No |
Comedo necrosis | |||
Absent | 0 | No | No |
Present | 1 | No | Yes |
Ki67 labeling index (%) | |||
< 1 | 0 | No | No |
1–3 | 1 | Yes | Yes |
> 3 | 2 | No | No |
Catecholamine type | |||
Epinephrine type (E or E + NE) | 0 | No | No |
Norepinephrine type (NE or NE + DA) | 1 | Yes | Yes |
Non-functioning type | 0 | No | No |
Total maximum score | 10 | 3 | 6 |