Histologic Grading of Radiation Effect on Prostate Carcinoma

The histologic effect of radiation therapy on prostate carcinoma can be graded based on the nuclear and cytoplasmic changes in the tumor cells.

Parameters:

(1) cytoplasmic changes

(2) nuclear changes

Parameter	Finding	Points
cytoplasmic changes	no identifiable radiation effect	0
	swelling and microvesicular change	1
	extensive vacuolization including macrovesicular change; voluminous cytoplasm	2
	indistinct or ruptured cytoplasm; lipofuscin pigment accumulation; glands when present are dilated; tumor often occurs as just single cells with no glandular formation	3
nuclear changes	no identifiable radiation effect	0
	some swelling or smudging of nuclei, but nucleoli still identifiable	1
	smudged and distorted chromatin; nucleoli rare or absent. large bizarre nuclei	2
	pyknotic, small, condensed nuclei	3

(from Table 2, page 83)

where:

• usually high nuclear and cytoplasmic scores co-exist

• cells with a high combined score may resemble histiocytes, but will be PSA positive on immunostaining

radiation effect score =

= (points for cytoplasmic changes) + (points for nuclear changes)

Interpretation:

• minimum score: 0

• maximum score: 6

To read more or access our algorithms and calculators, please log in or register.