Rule 1: Prostatic carcinoma is suspected always on low power examination.
Rule of "Toos" (at low magnification):
1. Too small glands
2. Too crowded glands (with back to back arrangement)
3. Too clear glands
Three criteria for confirmation of malignancy (at high magnification):
1. Enlarged nuclei
2. Prominence of nucleoli
3. Loss of basal cells
Additional features that indicate a malignancy:
1. Crystalloids
2. Glomerulations
3. Circumferential perineural invasion
Figure below - Shows benign prostatic acini with basal cells and luminal cells
Additional features that indicate a malignancy:
1. Crystalloids
2. Glomerulations
3. Circumferential perineural invasion
Figure below - Shows benign prostatic acini with basal cells and luminal cells
Figures below - Prostatic adenocarcinoma
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