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Prostate
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Gleason Grading Schema for Prostatic Adenocarcinoma
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Gleason Pattern |
Histological Features |
Note |
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1 |
Lobular masses, uniform small glands, no invasion |
* |
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2 |
Lobular archetectue, irregular, fairly well circumscribed but infiltrate beyond the lobular margins into the surrounding non-neoplastic gland, +/- cribriform pattern |
* |
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3 |
Irregular discreet individual glands with considerable variation in the size and shape infiltrate among non-neoplastic prostatic lobules. Large glands with a “perfect” cribriform pattern (i.e. rounded smooth contours and round, rigid evenly spaced secondary spaces. |
# |
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4 |
Gland fusion, sheets of large cells with pale cytoplasm (like renal cell carcinoma). infiltrative growth, +/- glands. Very large cribriform coalescent glands with irregular contours and unevenly spaced secondary spaces. |
+ |
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5 |
Sheets of anaplastic cells, solid sheets +/- foci of glands, cords, single cells, or nests. Solid nests with comedo necrosis |
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Score: |
Final score is the sum of the numbers assigned to the two major patterns, i.e. score = primary + secondary [e.g. Gleason score 7 (= 3 + 4)]. |
$ |
* Patterns 1 and 2 are almost never practically used in routine practice.
# Patterns 3 and 4 are the most frequently encountered. It is important to specify which one is the primary (main) pattern (has to be >50% of the total pattern seen). The secondary pattern is the minority of the tumor (< 50%, but at least 5%, of the pattern of the total tumor).
+ Pattern 5 is more often present as a minor component co-existing with dominant patterns 3 and 4. This is called “tertiary” pattern when there is a small component of a third (generally more aggressive) pattern. It is recommended that the tertiary pattern-5 should also be included in the grading.
$ Do not grade if the tumor has been treated.
MDAH [or BRODERS (MAYO)] Grading Schema for Prostatic Adenocarcinoma
MOSTOFI Grading Schema for Prostatic Adenocarcinoma
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