Prostatic carcinoma variants
Atypical cribriform lesions
Reviewers: Komal Arora, M.D., (see Reviewers page)
Revised: 21 November 2014, last major update March 2012
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● Represents cribriform high-grade PIN (cribriform HGPIN) or intraductal carcinoma (IDC-P, Am J Surg Pathol 2001;32:649)
● 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)
● Cribriform glands lined by cytologically malignant cells with partial or complete basal cell lining
● Repeat biopsy strongly recommended to rule out unsampled carcinoma
● 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
End of Prostate > Other carcinomas > Atypical cribriform lesions
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