The diagnostic criteria of prostate cancer are:

 

1. Architectural atypia

This is most important and often sufficient for a diagnosis of cancer.

2. Cellular atypia

There is usually also some nuclear atypia, including nuclear enlargement, which is helpful, especially in difficult cases with minimal cancer. The atypia is sometimes very mild and you may need to search for it at high power.

Most cases are solved utilizing criteria 1+2.

3. Immunohistochemistry

Can be used when 1+2 is not enough. Do not overinterpret the stains. Morphology is more important. Remember: to diagnose as cancer it needs to look like cancer.

4. Specific features

Relatively rarely seen. Typically found in cases that are already obvious cancers based on 1+2.