PASS scoring scale for pheochromocytoma of the adrenal gland

Feature	Score if present (number of points assigned)
Large nests or diffuse growth (>10 percent of tumor volume)	2
Central (middle of large nests) or confluent tumor necrosis (not degenerative change)	2
High cellularity	2
Cellular monotony	2
Tumor cell spindling (even if focal)	2
Mitotic figures >3/10 HPF	2
Atypical mitotic figure(s)	2
Extension into adipose tissue	2
Vascular invasion	1
Capsular invasion	1
Profound nuclear pleomorphism	1
Nuclear hyperchromasia	1
	Total: 20

PASS: Pheochromocytoma of the Adrenal gland Scaled Score; HPF: high-powered field.

Reproduced with permission from: Thompson LD. Pheochromocytoma of the Adrenal gland Scaled Score (PASS) to separate benign from malignant neoplasms: a clinicopathologic and immunophenotypic study of 100 cases. Am J Surg Pathol 2002; 26:551. Copyright © 2002 Lippincott Williams & Wilkins.

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PASS scoring scale for pheochromocytoma of the adrenal gland