In Gleason grades 1 and 2 the cancer cells closely resemble normal prostate cells. They are the least important grades because they occur infrequently in the general population and because they confer a prognostic benefit which is only slightly better than grade 3.
Both of these grades are composed by mass; in grade 2 they are more loosely aggregated, and some glands wander into (invade) the surrounding muscle (stroma).
Gleason grades of 1 and 2 are assigned today only to men whose cancer is initially identified after a type of surgery called a transurethral resection of the prostate, and because Gleason grade 1 is essentially “normal” tissue, it is almost never, ever assigned.
Figure 2: Grade 1 (left) and grade 2 (right) prostate adenocarcinoma. Both have pale cells and well formed, separate glands with lumens. Grade 1 is more compact (less invasive) than grade 2.
Department of Urology, Stanford University School of Medicine.
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