- Changes in tumor cells are variable, but in general, the tumor starts looking worse - the Gleason's score appears to go up although the prognosis doesn't change (which is why you cannot render a Gleason's grade on a treated tumor).
- Tumor cells had foamy vacuolated cytoplasm and pleomorphic nuclei (image A).
- Benign prostate glands become atrophic with enlargement of the nuclei (but nuclear to cytoplasmic ratio remains the same).
- Tumor composed of shrunken glands or single cells with small hyperchromatic or pyknotic nuclei and abundant clear (xanthomatous) cytoplasm. (may look like histocytes) (image B).
- Because of the shrunken glands or single cells, sometimes the tumor is difficult to find in resections.
- Benign prostate glands become atrophic; there is basal cell hyperplasia and urothelial metaplasia.
Remember – because of artifactual alteration; do not render a Gleason's grade on treated prostate cancer!