Prostate Cancer : Update on Grading and Reporting - 05/11/22

Doi : 10.1016/j.path.2022.07.008

Ezra Baraban, MD ^a,^⁎ , Jonathan Epstein, MD ^a,^b,^c,^⁎
^a Department of Pathology, Johns Hopkins Medical Institutions, 401 North Broadway, Weinberg Building, Room 2242, Baltimore, MD 21287, USA
^b Department of Urology, Johns Hopkins Medical Institutions, 401 North Broadway, Weinberg Building, Room 2242, Baltimore, MD 21287, USA
^c Department of Oncology, Johns Hopkins Medical Institutions, 401 North Broadway, Weinberg Building, Room 2242, Baltimore, MD 21287, USA

^∗Corresponding author. Department of Pathology, Johns Hopkins Medical Institutions, 401 North Broadway, Weinberg Building, Room 2242, Baltimore, MD 21287, USADepartment of PathologyJohns Hopkins Medical Institutions401 North Broadway, Weinberg Building, Room 2242BaltimoreMD21287USA

Abstract

The Gleason scoring system and Grade Group systems facilitate accurate grading and reporting of prostate cancer, which are essential tasks for surgical pathologists. Gleason Pattern 4 is critical to recognize because it signifies a risk for more aggressive behavior than Gleason Pattern 3 carcinoma. Prostatic adenocarcinoma with radiation or androgen therapy effect, with aberrant P63 expression, or with Paneth cell–like differentiation represent pitfalls in prostate cancer grading because although they display architecture associated with aggressive behavior in usual prostatic adenocarcinoma, they do not behave aggressively and using conventional Gleason scoring in these tumors would significantly overstate their biologic potential.

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Keywords : Prostate cancer, Gleason scoring, Grade groups, Intraductal carcinoma, Prostatic adenocarcinoma with aberrant P63 expression, Prostatic adenocarcinoma with Paneth cell–like differentiation