There is no consensus regarding grading after cryoablation therapy, and most pathologists, the authors included, routinely report Gleason grade
Although apparently separate in the 2-dimensional images of routine microscopy (Figure 2, c), 3D renderings demonstrated that the glands of Gleason grade
3 adenocarcinoma in fact interconnect to form a complex array of intertwined tubules (Figure 2, d).
For instance, in a situation where the primary Gleason grade
is 3, the secondary is 4, and there is less than 5% Gleason 5, the report should indicate a Gleason score of 7 (3 + 4) with tertiary Gleason pattern 5.
Surgically treated men also had the best 7-year progression-free survival rate of the four treatment categories after adjustment for clinical stage, preoperative prostate-specific antigen (PSA), Gleason grade
, and age at diagnosis, Julie M.
Schalken's laboratory demonstrates the potential clinical utility of the PCA3 gene in detecting clinically important cancers without the over-detection of the less-important low Gleason grade
tumors," said Dr.
In the original Gleason grading system, malignant glands with a cribriform pattern were assigned Gleason grade
The issue of the accuracy in determining the true Gleason grade
in a biopsy was also considered.
On microscopic examination, the glass slides of all cases were reviewed for pathologic evaluation of T stage, Gleason grade
and score, tumor size, extraprostatic extension, resection margin involvement, seminal vesicle invasion, lymphatic invasion, and lymph node and other organ involvement by 2 pathologists.
2%) had lower Gleason grade
after RP, while 91 (75.
He examined 1,317 consecutive untreated radical prostatectomies in 3-mm step-sections and measured the volume of the largest cancer, the percent that was Gleason grade
4/5, and less important histologic parameters.
Gleason Grading of Unusual Subtypes and Patterns of Prostate Cancer Histologic Type or Pattern Gleason Grade
Foamy gland pattern Graded by underlyingarchitecture Pseudohyperplastic 3 Atrophic 3 Large duct carcinoma 4;with evidence of necrosis, 5 Signet ring cell carcinoma 5 Small cell carcinoma Not graded Adenosquamous and squamous Not graded carcinoma Sarcomatoid carcinoma Not graded Glomeruloid pattern 3 or 4 Collagenous micronodules Usually 3, graded by underlying architecture (subtract collagenous micronodules from analysis) Mucinous (colloid) carcinoma 3 or 4, graded by underlying architecture
Prostate biopsy information included: the number of cores obtained, the number of cores positive for cancer, the biopsy sum of each core, and the proportion of Gleason grade
3 cancer in each core.