Grading of Prostate Cancer
Slideshow

Gleason Pattern 2

 

GP2 consists of round or oval glands with blunt ends. The glands are less infiltrating than those of GP3 and the glandular size is less variable. Cytology is not included in the Gleason system but these tumors are typically TZ tumors with columnar epithelium, light staining cytoplasm and relatively mild nuclear atypia.

 

There are several problems with GP2:

  1. It is difficult to draw the line between GP2 and GP3. How small glands can we allow in GP2?
  2. GP2 is usually mixed with GP3. This makes it difficult to find good examples of pure GP2.
  3. On needle biopsy we cannot see the entire infiltrating border of the tumor which makes it difficult to determine if it is a GP2 or GP3.
  4. Does the separation of GP2 and GP3 have clinical relevance? Tumors of these grades may have similar prognosis when found on needle biopsy.

 

It is therefore recommended that GP2 should not be diagnosed in biopsies.

Because of the difficulties described above many pathologists avoid diagnosing GP2 in all specimens.

 

Img05_13074GG2

Pale staining, oval glands with blunt ends typical of GP2.

 

GG2 SP92511_20x

Pale staining, oval glands with blunt ends typical of GP2 mixed with a few smaller glands and with some spacing between the glands. Some would still accept this as GP2.