Clinical calculator summary
Original 2002 Thompson PASS
Clinical calculator summary
Original 2002 Thompson PASS
A 12-feature weighted histopathology score ranging from 0 to 20.
Evidence-based context for fast calculator use
- Purpose:
- Reproduce the original PASS total and indicate whether it is below or at/above the original score-4 threshold.
- Population:
- Adequately sampled, resected adrenal pheochromocytoma assessed by a pathologist.
- Factors:
- Eight 2-point histologic features, Four 1-point histologic features, Original threshold at total score 4
- Reference:
- Thompson LD. Am J Surg Pathol. 2002;26(5):551-566.
PASS Score (Pheochromocytoma)
Original PASS feature: 2 points when present.
Original PASS feature: 2 points when present.
Original PASS feature: 2 points when present.
Original PASS feature: 2 points when present.
Original PASS feature: 2 points when present.
Original PASS feature: 2 points when present.
Original PASS feature: 2 points when present.
Original PASS feature: 2 points when present.
Original PASS feature: 1 point when present.
Original PASS feature: 1 point when present.
Original PASS feature: 1 point when present.
Original PASS feature: 1 point when present.
Clinical Context & Background
Original 2002 Thompson PASS = sum of eight 2-point findings and four 1-point findings (range 0-20). Total 0-3 is below the original threshold; total 4-20 is at or above the original threshold.Reference Data
| Original PASS feature | Points when present |
|---|---|
| Extension into periadrenal adipose tissue | 2 |
| More than 3 mitoses per 10 HPF | 2 |
| Atypical mitotic figures | 2 |
| Central or confluent tumor necrosis, excluding degenerative change | 2 |
| Tumor-cell spindling, even if focal | 2 |
| Cellular monotony | 2 |
| Large nests or diffuse growth involving more than 10% of tumor | 2 |
| High cellularity | 2 |
| Profound nuclear pleomorphism | 1 |
| Capsular invasion | 1 |
| Vascular invasion | 1 |
| Nuclear hyperchromasia | 1 |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- After specialist histopathology assessment of an adequately sampled, resected adrenal pheochromocytoma.
- Use only when every one of the 12 source-defined features has been explicitly assessed.
How To Interpret
- Scores 0-3 are below the original PASS threshold.
- Scores 4-20 are at or above the original PASS threshold; this does not diagnose malignancy or quantify individual metastatic risk.
What To Do Next
- Document the individual histologic findings and total in the pathology context.
- Integrate staging, genetics, biochemical findings, imaging, expert pathology review, and longitudinal follow-up separately.
Limitations
- Not for extra-adrenal paraganglioma, limited biopsy, or cytology material.
- Substantial interobserver variability and limited positive predictive performance have been reported.
- Do not use PASS alone to declare a tumor benign or malignant or to prescribe treatment or surveillance.
- All pheochromocytomas may have metastatic potential.
Validated Population
Resected adrenal pheochromocytoma in the original 2002 pathology cohort.
Original threshold
Two present 2-point findings produce PASS 4, which is reported as at or above the original threshold without a benign/malignant label.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed cases passed through all twelve visible production controls at scores 0, 3, and the exact threshold 4.
- Two-point and one-point features summed correctly while the output retained the neutral below/at-or-above original PASS threshold wording.
- No unexpected N/A, stale control, literal undefined/null value, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/pass-score-Pheochromocytoma-2026-08-03.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
- Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/pass-score-Pheochromocytoma.json.
: Full validation test
- 12,640/12,640 exhaustive combination, source-definition, strict-input, UI, trace, scope, registry, report, and isolation checks passed.
- This verifies implementation of the selected historical score, not independent clinical validation, diagnosis, individualized metastatic-risk prediction, or treatment guidance.
: Calculation, input-contract, and scope correction
- Removed favorable defaults, arbitrary Object.values summation, Number coercion, weighted UI values, and missing/extra-field acceptance.
- Required all 12 findings as exact absent/present assessments and applied the original eight 2-point and four 1-point weights inside the shared engine.
- Replaced benign/malignant and management claims with the original threshold wording, adrenal resection scope, exclusions, and modern observer-variability limitations.
Included in the current validation report.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Related Tools
Frequently Asked Questions
Does PASS diagnose malignancy?
No. The score reproduces a historical histopathology system. It does not establish benignity or malignancy and cannot reliably provide an individualized metastatic-risk estimate.
Can PASS be used for paraganglioma or biopsy material?
No. This implementation is restricted to adequately sampled, resected adrenal pheochromocytoma and should not be applied to extra-adrenal paraganglioma, limited biopsy, or cytology.
How should a score of 4 be interpreted?
A total of 4 is at the original Thompson threshold. Because later studies identified observer variability and limited positive predictive performance, the result is presented only as a historical threshold classification.
Evidence-based oncology decision support. Verify with clinical guidelines.