Modern Pathology

TABLE 1

FROM:

Gleason grading and prognostic factors in carcinoma of the prostate

Peter A Humphrey

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Table 1. Gleason grading system for prostatic adenocarcinoma

Pattern Tumor shape and borders stromal invasion Tumor cell arrangements Gland size
1Nodular, well-defined and smooth edgesPushingSingle, round to oval, closely packed, but separate glandsMedium
2Masses less well-defined and less well-circumscribedSome gland separation at tumor edgeSingle, separate, round to oval glands, with more variation in gland size and shape, and loosely packed with stromal separation (up to one gland diameter, on average)Medium
3AIll-defined infiltrating edgesIrregular extensionSingle separate glands of variable shape and size, with elongated, angular and twisted forms, usually with wide stromal separationMedium
3BIll-defined infiltrating edgesIrregular extensionSame as 3A but glands are smallerSmall to very small
3CMasses and cylinders with smooth rounded edgesExpansilePapillary and cribriform epithelium, without necrosisMedium to large
4ARaggedly infiltrativeDiffusely permeativeFused glands, creating masses, cords, or chainsSmall, medium, or large
4BRaggedly infiltrativeDiffusely permeativeSimilar to 4A, but cells have cleared cytoplasm=hypernephromatoid variantSmall, medium, or large
5ASmooth, rounded cylindersExpansilePapillary, cribriform or solid masses with central necrosis=comedocarcinomaVariable
5BRaggedly infiltrativeDiffusely permeativeMasses and sheets of anaplastic carcinoma, with a few tiny glands or signet ring cellsSmall
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