nuclear grade 1 (one point)
nuclear grade 2 (two points)
nuclear grade 3 (three points)
The ability to discern nuclear characteristics is significantly dependent on the type of fixative. [see specimen processing] One excellent fixative, Hartmann's, destroys RBCs [red blood cells] which are the internal size ruler (an RBC is 6-7 microns wide in histological sections) for measuring nuclear size. In a given case, we might use different fixatives (10% neutral buffered formalin [10% NBF] or B5 or Hartmann's or M2).
| tumor nuclei have diffuse chromatin, absent/inapparent nucleoli and average no larger than
1 to 1.5 RBC diameters: nuclear grade 1 (one point) |
| tumor nuclei have coarse chromatin, present but infrequent nucleoli and average no larger than
1.5 to 2.0 RBC diameters: nuclear grade 2 (two points) |
| tumor nuclei have vesicular chromatin, frequent nucleoli and average larger
>2 RBC diameters: nuclear grade 3 (three points) |
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