Variants of Gleason Pattern 5 (part 3)

 

Cytoplasmic vacuoles are occasionally seen and should not be misinterpreted as glandular lumina. An extreme example is signet-ring-like cancer which is a variant of GP5 with numerous cytoplasmic vacuoles without mucin.

Vacuolated cells in GP5. These spaces are not true lumina. When there are abundant vacuoles, the tumor may be considered signet-cell like cancer. The vacuoles do not contain mucin.