Gleason Pattern 4

 

This grade includes different patterns where the cancer cells attempt to form glands but still do not form complete, separate glands. There are several morphological variants of this partial glandular differentiation. In all of them, we can see how the cancer cells have a differentiation towards adenocarcinoma but fail to make fully developed glandular units.

 

1. Cribriform glands

 

2. Fused glands

 

3. Poorly formed glands

 

4. Glomeruloid glands