Prostatic carcinoma variants
Atypical cribriform lesions

Topic Completed: 1 March 2012

Revised: 27 February 2019

Copyright: 2003-2019,, Inc.

PubMed search: prostatic atypical cribriform lesions

Komal Arora, M.D.
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Cite this page: Arora K. Atypical cribriform lesions. website. Accessed September 17th, 2019.
Definition / general
  • Represents cribriform high-grade PIN (cribriform HGPIN) or intraductal carcinoma (IDC-P, Am J Surg Pathol 2001;32:649)
  • Rare
  • 55% had cancer on follow-up; predictors were positive digital rectal examination or transrectal ultrasound, bilateral atypical cribriform glands, detached cribriform glands (Am J Surg Pathol 2001;25:147)
  • High grade cribriform PIN may be a late event in tumor progression, more compatible with the intraductal spread of tumor than dysplasia (Am J Surg Pathol 1998;22:840)
Microscopic (histologic) description
  • Cribriform glands lined by cytologically malignant cells with partial or complete basal cell lining
  • Repeat biopsy strongly recommended to rule out unsampled carcinoma
Differential diagnosis
  • Clear cell cribriform hyperplasia: usually in transition zone, not on needle biopsy; no cytologic atypia; has clear cells and obvious basal cell layer
  • Central zone glands (normal): no cytologic atypia, tall pseudostratified nuclei with eosinophilic cytoplasm
  • Cribriform basal cell hyperplasia: may have prominent nuclei, but usually in transition zone and not on needle biopsy; this pattern is rare, and usually represents fused glands and not true cribriform glands
  • Cribriform carcinoma: Gleason patterns 3 or 4
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