Histopathology Grading Lab

Tissue Field

Tissue architecture

Diagnostic Controls

Nuclear atypia 20%

Tubule / gland formation 2

Live Readouts

N : C ratio

1 : 5.0

Mitoses / field

Nottingham grade (tubules + pleomorphism + mitoses)

5 — Grade I (well differentiated)

How it works

Pathologists score a tumor field using the Elston–Ellis modification of the Scarff–Bloom–Richardson (Nottingham) system: three components, each 1–3 points, summed to a total of 3–9.

N:C ratio  = nucleus_diameter / cell_diameter
             ≈ 0.2 + 0.8 · (atypia / 100)

Pleomorphism score  1  if atypia < 33%
                     2  if 33% ≤ atypia < 66%
                     3  if atypia ≥ 66%

Mitotic count/field = round(12 · atypia / 100)
Mitotic score        1 if count ≤ 3, 2 if count ≤ 7, else 3

Nottingham total = tubule_score + pleomorphism_score + mitotic_score
Grade I   : 3–5  (well differentiated)
Grade II  : 6–7  (moderately differentiated)
Grade III : 8–9  (poorly differentiated)

Nuclear atypia slider — the single biological knob: as it rises, nuclei enlarge (raising the N:C ratio), vary more in size and shape (pleomorphism), and more cells are caught mid-division (mitotic figures, shown in magenta).
Tubule / gland formation — how well the tissue still organizes into recognizable glandular structures; scored independently by the pathologist, so it's a free control here too.
Tissue architecture — the four basic tissue types (epithelial, connective, muscle, nervous) arrange cells differently under the microscope; switching it changes the field layout, not the grading math.

Real-world relevance: this exact three-factor sum is what turns a stained biopsy slide into the grade on a pathology report, which in turn drives cancer treatment decisions.

Nucleus (hematoxylin) Cytoplasm (eosin) Mitotic figure

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