Variants of Gleason Pattern 5 (part 1)

 

Solid strands of epithelium and/or single cells infiltrating the stroma is the most common variant of GP5. Although cytological features are not part of the Gleason grading system the nuclei of these cancer cells often look immature. Occasionally they may be small and easily missed at low power. They may also resemble plump fibroblasts or histiocytes in the prostatic stroma.

 

 

Strands and single cells in GP5. Plump cells are seen dispersed in the stroma between benign glands. 

 

Strands and single cells in GP5. There are numerous single cancer cells in the stroma with nuclei that are too large for benign stromal cells. There is also a minor component of GP4 to the left.