CLO20-033: A Study of Pathological Characteristics of Malignant Cribriform Prostatic Lesions

Background: Prostatic lesions are becoming increasingly complex and showing a wide variety of morphology, in which, the cribriform architecture is particularly common and represents a broad spectrum of entities, varying from normal structures within central zone or benign lesions to premalignant lesions and frank malignancies. In Vietnam, there were few studies of prostatic histopathological features, especially, no studies on cribriform lesions of prostate have been done. Objectives: To study the pathological features of malignant cribriform prostatic lesions on biopsy. Materials and Methods: A cross-sectional descriptive study with all prostatic intraepithelial neoplasia and prostatic adenocarcinoma cases diagnosed at Medic Medical Center from 01/01/2013 to12/31/2015. Results: The mean age of patients was 74,03 ± 8,79; 85,39% cases had serum PSA≥20 ng/ml; the majority had Gleason score 8-9 (59,6%); 93,5% HGPIN and 100% intraductal carcinoma associated with adenocarcinoma, especially, there was a statistical significance between Gleason score 8-9 and intraductal carcinoma (χ 2, P < 0,0001); between Gleason score 7 and HGPIN (χ 2, P = 0,025);68,19% cases had loose cribriform architecture;79,37% cases had large cribriform; 83,38% cases had detached cribriform fragments and associated with Gleason score 8-9 (χ 2; P=0,027); 6,9% cases had periacinar halo but not statistically related to Gleason score 7 (χ 2; P=0,111); 61,61% cases had braching contour; 78,2% cases had slit-like spaces; 82,81% cases had sharp luminal border; 17,19% cases had intraluminal blue-mucin, 40,69% cases had amorphous pink material, 27,22% cases had crystalloids, 10,03% cases had comedo-necrosis; 89,68% cases had group 1 nuclear, 62,75% cases had group 3 nucleoli; 81,95% cases had amphophilic cytoplasm; 21,2% cases had neovascularity resembling glomus body and associated with Gleason score 8-9 (χ 2; P=0,008). Conclusion: Malignant cribriform glands should be assigned a Gleason pattern 4, regardless of morphology. High grade prostatic adenocarcinoma was always associated with intraductal carcinoma. Three new features, such as attaching cribriform fragments, periacinar halo and neovascularity resembling glomus body, are very useful clues for pathologists to diagnose adenocarcinoma.

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Corresponding Author: Tam Bui, MD
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