Gleason Grading of Prostatic Carcinoma

Lars Egevad, M.D., Ph.D.
Associate Professor of Pathology
Karolinska Hospital
Stockholm, Sweden

William C. Allsbrook, Jr., M.D.
Professor Emeritus of Pathology
and Surgery (Urology)
Medical College of Georgia
Augusta, Georgia

Jonathan I. Epstein, M.D.
Professor of Pathology, Urology, and Oncology
The Reinhard Professor of Urologic Pathology
Director of Surgical Pathology
The Johns Hopkins Hospital
Baltimore, MD

Grading Prostatic Carcinoma Variants

Several morphological variants of prostatic carcinoma have been described - e.g. mucinous, ductal, small cell carcinoma. Typically, they are almost always combined with conventional prostatic carcinoma. Therefore, their effect on the prognosis is difficult to assess. It is doubtful whether prostatic carcinoma variants should be graded at all. In cases with a minor component of a variant of prostatic carcinoma, we recommend that a Gleason score be assigned to the conventional prostatic carcinoma present in the specimen with the prostatic carcinoma variant noted but not graded.

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