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Cited by 715Adrenal and Paraganglionic TumorsNeuroendocrine Tumor Research AdvancesNeurofibromatosis and Schwannoma Cases

Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) to Separate Benign From Malignant Neoplasms: A Clinicopathologic and Immunophenotypic Study of 100 Cases

Thompson, Lester D. R.·2002·The American Journal of Surgical Pathology
DOI 10.1097/00000478-200205000-00002
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Abstract

No comprehensive series has evaluated the histologic features of pheochromocytoma to separate benign from malignant pheochromocytoma by histomorphologic parameters only. Fifty histologically malignant and 50 histologically benign pheochromocytomas of the adrenal gland were retrieved from the files of the Armed Forces Institute of Pathology. The patients included 43 females and 57 males, with an age range of 3-81 years (mean 46.7 years). Patients usually experienced hypertension (n = 79 patients). The mean tumor size was 7.2 cm (weight was 222 g). Histologically, the cases of malignant pheochromocytomas of the adrenal gland more frequently demonstrated invasion (vascular [score = 1], capsular [score = 1], periadrenal adipose tissue [score = 2]), large nests or diffuse growth (score = 2), focal or confluent necrosis (score = 2), high cellularity (score = 2), tumor cell spindling (score = 2), cellular monotony (score = 2), increased mitotic figures (>3/10 high power fields; score = 2), atypical mitotic figures (score = 2), profound nuclear pleomorphism (score = 1), and hyperchromasia (score = 1) than the benign tumors. A Pheochromocytoma of the Adrenal gland Scaled Score (PASS) weighted for these specific histologic features can be used to separate tumors with a potential for a biologically aggressive behavior (PASS > or =4) from tumors that behave in a benign fashion (PASS <4). The pathologic features that are incorporated into the PASS correctly identified tumors with a more aggressive biologic behavior. Application of these criteria to a large cohort of cases will help to elucidate the accuracy of this grading system in clinical practice.

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Crossref · 10.1097/00000478-200205000-00002

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49 of 49 references verified0 citation errors · 0 not checkable

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  • In 2002, Thompson described the PASS tool, based on 12 histological features, to distinguish benign and malignant pheochromocytomas.

    “In 2002 Thompson described a tool, Pheochromocytoma of the Adrenal gland Scaled Score (PASS), based on the presence or absence of 12 specific histological features to allow better distinction between benign and malignant tumors (119).”

    From Adrenal incidentaloma (2020) · cites this paper as [119]

  • Tumors with a PASS score >4 were defined as having malignant potential, whereas those with a lower score were considered benign.

    “Tumors with a PASS score >4 were defined as having malignant potential, whereas those with a lower score were considered benign.”

    From Adrenal incidentaloma (2020) · cites this paper as [119]

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Authors
Thompson, L. D. R.
Affiliations
United States Department of Defense (US)
Corresponding author
Thompson, Lester D. R.
ORCID
Thompson, Lester D. R.
Venue
The American Journal of Surgical Pathology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2002-05
Volume
26
Issue
5
Pages
551-566
ISSN
0147-5185 (ISSN-L)
DOI
10.1097/00000478-200205000-00002
OpenAlex
W2057451047
Cited by
715
References
49
Citations by year
2026: 33 · 2025: 36 · 2024: 45 · 2023: 41 · 2022: 48 · 2021: 44 · 2020: 39 · 2019: 39 · 2018: 40 · 2017: 48 · 2016: 38 · 2015: 30 · 2014: 33 · 2013: 25 · 2012: 25
FWCI
7.32
Type
journal article
Language
en
Open access
closed
Locations
  • The American Journal of Surgical Pathology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
  • Health Sciences › Medicine › Neurology › Neurofibromatosis and Schwannoma Cases
Keywords
pheochromocytoma, adrenal tumors, benign versus malignant differentiation, PASS score, tumor invasion, mitotic activity, nuclear pleomorphism, tumor necrosis, cellularity, tumor aggressiveness
MeSH terms
Adolescent, Adrenal Gland Neoplasms, Adult, Aged, Aged, 80 and over, Cell Nucleus, Child, Child, Preschool, Female, Humans, Immunohistochemistry, Male, Middle Aged, Mitosis, Pheochromocytoma, Prognosis, Retrospective Studies, Biomarkers, Tumor, Immunophenotyping

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