JH noted PNI at Core 6, like the first report, but at the original Core 3 w/ PNI, have described it: "Suspicious for Extraprostatic Extension". Is that just a "Pre PNI"?
Men with PNI at biopsy are statistically more likely to have adverse path features (extraprostatic extension, seminal vesicle invasion, positive surgical margins...) than men without no PNI. The PNI itself isn't in question in your slides, but rather it's implication is that this makes EPE more likely, hence the "suspicious for EPE." (Note that PNI is found somewhere
in the majority of whole prostate examined. I believe when PNI is already seen in the small amount of tissue of a biopsy, it is probably more pervasive, and the PCa has therefore had more time to grow along the nerves out of the capsule (EPE) or into neighboring anatomical structures.
Post Edited (DjinTonic) : 2/21/2020 11:28:16 AM (GMT-7)