Prostatic adenocarcinoma, GS 7 (3+4), GD (70% / 30%)

"On prostate biopsy, glomerulations are exclusively associated with carcinoma and not associated with benign mimickers. However, the Gleason grading of carcinoma with glomerulations on needle biopsy remains controversial. ..... though they resemble a renal glomerulus superficially, most do not contain a true fibrovascular core. ..... glomerulations represent an early stage of cribriform pattern 4 cancer and, until follow-up data are available, are best graded as Gleason pattern 4." - ref 1. ____ "Glomeruloid features were not observed in any benign or premalignant lesions, including hyperplasia and intraepithelial neoplasia. Glomeruloid structures in the prostate represent an uncommon but distinctive pattern of growth that is specific for malignancy. Glomeruloid features may be a useful diagnostic clue for malignancy, particularly in some challenging needle biopsy specimens. This pattern of growth is usually seen in high-grade adenocarcinoma, often with extraprostatic extension." - ref 2. ____ Similar feature is described in one case of ductal carcinoma in situ (DCIS) of breast - ref 3.

1) Lotan TL, Epstein JI. Gleason grading of prostatic adenocarcinoma with glomeruloid features on needle biopsy. Hum Pathol. 2009 Apr;40(4):471-7. ____ 2) Pacelli A, Lopez-Beltran A, Egan AJ, Bostwick DG. Prostatic adenocarcinoma with glomeruloid features. Hum Pathol. 1998 May;29(5):543-6. ____ 3) Gobbi H, Simpson JF, Jensen RA, Coogan AC, Page DL. Prostatic adenocarcinoma with glomeruloid features. Hum Pathol. 1999 Jan;30(1):111-2.