Prostate
Prostatic carcinoma variants
Atypical cribriform lesions

Authors: Komal Arora, M.D. (see Authors page)

Revised: 8 August 2016, last major update March 2012

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PubMed search: prostatic atypical cribriform lesions
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)
Micro 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