Histologic Grading System of Hruban and Fukushima for a Pancreatic Adenocarcinoma

Description

Hruban and Fukushima reported a grading system for the histologic classification of pancreatic adenocarcinomas of ductal origin. The authors are from the Johns Hopkins University and the University of Tokyo.

Parameters:

(1) glandular architecture

(2) mucin production within neoplastic cells

(3) mitotic activity per 10 high power (40x objective) microscopic field (hpf)

(4) nuclear atypia/pleomorphism

Parameter	Grade I	Grade II	Grade III
glandular architecture	well-differentiated, duct-like	moderately differentiated duct-like structures, tubular glands	poorly formed or pleomorphic glands, solid areas, single malignant cells
mucin production	abundant	irregular	none or little
mitotic activity	<= 5 per 10 hpf	6 - 10 per 10 hpf	>= 11 per 10 hpf
nuclear pleomorphism	minimal to mild	moderate	marked, with increased nuclear size and bizarre mitoses

The final grade should be based on the worst degree of differentiation seen in a significant proportion of the tumor.

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Description

Specialty

ICD-10