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**May be confused with stromal/lymphocytic infiltration. | **May be confused with stromal/lymphocytic infiltration. | ||
***Look for nucleoli, cells should be round (prostatic stroma cells are spindle cells). | ***Look for nucleoli, cells should be round (prostatic stroma cells are spindle cells). | ||
*Cords. | *Cords (strands). | ||
**Line of cells. | |||
**Should not be intermixed with clumps of cells (pattern 4). | |||
*Nests of cells with [[necrosis]] at centre. | *Nests of cells with [[necrosis]] at centre. | ||
Notes: | |||
*Pattern may be under-diagnosed.<ref name=pmid21997691>{{Cite journal | last1 = Fajardo | first1 = DA. | last2 = Miyamoto | first2 = H. | last3 = Miller | first3 = JS. | last4 = Lee | first4 = TK. | last5 = Epstein | first5 = JI. | title = Identification of Gleason pattern 5 on prostatic needle core biopsy: frequency of underdiagnosis and relation to morphology. | journal = Am J Surg Pathol | volume = 35 | issue = 11 | pages = 1706-11 | month = Nov | year = 2011 | doi = 10.1097/PAS.0b013e318228571d | PMID = 21997691 }} | |||
</ref> | |||
Image: [http://commons.wikimedia.org/wiki/File:Gleason_4_and_5_intermed_mag.jpg Gleason pattern 4 - small glands & Gleason pattern 5 - single cells (WC)]. | Image: [http://commons.wikimedia.org/wiki/File:Gleason_4_and_5_intermed_mag.jpg Gleason pattern 4 - small glands & Gleason pattern 5 - single cells (WC)]. |
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