Several refinements in GP 5 were also made in the 2014 ISUP consensus.1 Gleason pattern 5 now includes small solid cylinders, medium to large nests with rosettelike spaces, and focal but unequivocal
comedonecrosis (Figure 4, A and B).
Histopathologic analysis of the surgically removed prostate revealed adenocarcinoma of the prostate (Gleason score 7, pT3N0Mx) with chronic prostatitis and focal
comedonecrosis.
Ragged infiltrative single cells, cords or sheets without gland formation, small solid cylinders or any pattern with
comedonecrosis.
In addition, basaloid squamous cell carcinoma was also excluded due to the absence of
comedonecrosis, hyalinization of the stroma, or microcyst formation.
Established the UCS/VNPI algorithm that quantifies five measurable prognostic factors (tumor size, margin width, nuclear grade, age and
comedonecrosis) and aids in predicting local recurrence in conservatively treated patients.
Points are scored for the histological pattern, tumour cellularity,
comedonecrosis, vascular or capsular invasion, Ki-67 labeling, and catecholamine subtype.
It may also demonstrate a cribriform pattern,
comedonecrosis, along with perineural and vascular invasion [14].
A): Dynamic contrast- enhanced image disclosed a ring-like tumor focus; B): Enhancement rate 230%; C): Ascending enhancing mode and dynamic contrast-enhanced curve; D and E): Optical microscopic observation showed
comedonecrosis (white arrow) and fibrosis (black arrow) (HEA-100).
Comedonecrosis and a young age at diagnosis, reported by others to be also associated with histological upgrade, were not found significant in our study [25, 28].
They feature large ducts with solid, papillary, and
comedonecrosis areas (figure 1).
As such, these types of large-cell intraductal carcinomas are referred to as comedocarcinomas because of the central necrosis (
comedonecrosis).[11]
B, This (widely or frankly) invasive carcinoma ex pleomorphic adenoma of parotid with
comedonecrosis demonstrates more extensive invasion beyond the pleomorphic adenoma (bottom) component (hematoxylin-eosin, original magnifications X40 [A] and X20 [B]).