Table 3.
PASS and GAPP systems.
| PASS factors | Score | ||
|---|---|---|---|
| Large nests or diffuse growth (>10% of tumor volume) | 2 | ||
| Necrosis | 2 | ||
| High cellularity | 2 | ||
| Cellular monotony | 2 | ||
| Presence of spindle-shamed tumor cells | 2 | ||
| Atypical mitotic figures | 2 | ||
| Greater than 3 mitotic figures | 2 | ||
| Extension of tumor into adjacent fat | 2 | ||
| Vascular invasion | 1 | ||
| Capsular invasion | 1 | ||
| Profound nuclear pleomorphism | 1 | ||
| Nuclear hyperchromasia | 1 | ||
| Total | 20 | ||
| GAPP factors | Score | ||
| Histological pattern: | |||
| Zellballen | 0 | ||
| Large and irregular cell nest | 1 | ||
| Pseudorosette | 1 | ||
| Cellularity: | |||
| Low (<150 cells/U) | 0 | ||
| Moderate (150–250 cells/U) | 1 | ||
| High (>250 cells/U) | 2 | ||
| Comedo necrosis: | |||
| Absence | 0 | ||
| Presence | 2 | ||
| Vascular or capsular invasion: | |||
| Absence | 0 | ||
| Presence | 1 | ||
| Ki-67 labeling index: | |||
| <1% | 0 | ||
| 1–3% | 1 | ||
| >3% | 2 | ||
| Catecholamine type: | |||
| Epinephrine type (E or E + NE) | 0 | ||
| Norepinephrine type (NE or NE + AD) | 1 | ||
| Non-functioning type | 0 | ||
| Total maximum score | 10 | ||
U, number of tumor cells under ×400 magnification; E, epinephrine; NE, norepinephrine.