Quantitative assessment of cribriform intraductal carcinoma of the prostate is useful for risk stratification after radical prostatectomy.

HER-2-positive invasive cribriform carcinoma of the right breast: A case report

Aim: 7,12-Dimethylbenz[a]anthracene (DMBA) is a potent polycyclic aromatic hydrocarbon (PAH) widely used to induce mammary carcinogenesis in rodent models. This meta-analysis systematically reviews and synthesizes the evidence on the histopathological diversity of DMBA-induced breast tumors in rats and the molecular mechanisms underpinning this carcinogenesis. Materials and Methods: A systematic search of PubMed, Embase, Web of Science, and Scopus was conducted for studies published from inception to March 2024. Studies administering DMBA to female rat models and reporting detailed histopathological classification of resultant mammary tumors were included. Data on tumor incidence, latency, and type (adenocarcinoma, fibroadenoma, etc.) were extracted. Pooled incidence rates with 95% confidence intervals (CI) were calculated using a random-effects model. Molecular data on DMBA metabolism, DNA adduct formation, and oncogenic pathways were synthesized qualitatively. Results: 48 studies (n= 2,815 rats) were included. The pooled incidence of malignant mammary tumors (primarily adenocarcinomas) was 76.4% (95% CI: 70.1–82.7%, I² = 87%). The pooled incidence of benign tumors (primarily fibroadenomas) was 58.2% (95% CI: 49.5–66.9%, I² = 89%). A significant proportion of animals developed multiple tumor types. Histopathological analysis revealed a spectrum of lesions, including invasive ductal carcinomas, papillary carcinomas, cribriform carcinomas, and squamous cell carcinomas. Tumor development was highly dependent on the timing of DMBA administration relative to the animal's estrous cycle and age. The carcinogenic mechanism is initiated by cytochrome P450 (CYP1B1)-mediated metabolic activation to DMBA-3,4-dihydrodiol-1,2-epoxide, which forms stable DNA adducts, primarily with adenine residues, leading to consistent H-ras oncogene activation via a specific A→T transversion at the second nucleotide of codon 61. Conclusion: DMBA induction in rats produces a heterogeneous and reproducible profile of mammary tumors that closely mimics the heterogeneity of human breast cancer. The high incidence and predictable molecular pathogenesis, centered on ras activation, make the DMBA model an invaluable tool for studying breast cancer chemoprevention, tumor progression, and the efficacy of therapeutic interventions.

PurposeThis study aimed to determine whether the presence of intraductal carcinoma of the prostate or invasive cribriform carcinoma correlates with homologous recombination repair or mismatch repair gene alterations in patients with prostate cancer who have not undergone prior systemic treatment.Materials and methodsWe conducted a retrospective review of 347 systemic treatment-naïve prostate cancer patients who underwent genomic testing between January 2018 and May 2024 at a single tertiary center. Clinical and genomic characteristics were compared between groups with and without intraductal carcinoma of the prostate or invasive cribriform carcinoma. Predictive factors for homologous recombination repair gene mutations were identified through logistic regression.ResultsAmong the study population, 73.2% demonstrated intraductal or cribriform histologic features. Mutations in homologous recombination repair genes were detected in 24.8% of those with these features, and in 22.6% of those without. Mutations in mismatch repair genes occurred in 2.8% and 1.1% of the respective groups. No differences were observed in prostate-specific antigen levels, microsatellite instability, or tumor mutational burden. Logistic regression analysis identified Grade Groups (P < 0.001) and younger age at diagnosis (P = 0.041) as significant predictors of homologous recombination repair gene alterations. The presence of intraductal or cribriform patterns, however, did not predict such mutations (P = 0.827).ConclusionThe presence of intraductal carcinoma or cribriform growth patterns was not associated with increased likelihood of mutations in homologous recombination repair genes. These findings support the use of clinical parameters such as age and Grade Group, rather than histologic subtype alone, in guiding decisions for genetic testing.

BACKGROUND The skin is the largest organ of the human body and plays a critical role in maintaining homeostasis. It helps regulate body temperature, protects against physical and chemical environmental insults, and serves as a barrier to microbial invasion by acting as a vital interface between the internal body and the external environment. Skin neoplasms encompass a wide variety of tumors. Because they are heterogeneous in their cell of origin, biological behavior, treatment, and prognosis, their classification is often complex and can sometimes mislead clinicians in distinguishing clearly between malignant and benign entities. CASE REPORT In this article, we report the case of a previously healthy man who presented with a solitary subcutaneous left leg skin nodule. After appropriate clinical examination, surgical excision, radiological tests, and pathological analysis, it was ultimately diagnosed as cribriform tumor (previously known as primary cutaneous cribriform carcinoma), an exceedingly rare adnexal skin neoplasm, which has been reported approximately only 50 times in the scientific literature. We describe its clinical features and biological characteristics, and describe the diagnostic procedure and available treatment. Because of the rarity of this tumor and consequently the limited research and available data, diagnosis and treatment can be particularly challenging for histopathologists and clinicians. CONCLUSIONS This article provides additional insights and description of this extremely rare entity, cribriform tumor, contributing to the growing body of evidence and aiding clinicians in avoiding potential misdiagnosis with other malignant or benign skin neoplasms.

The management of localized prostate cancer (PCa) is shifting towards tissue-preserving strategies such as active surveillance and focal therapies. Intermediate-risk PCa, especially ISUP Grade Group 2 (GG2), encompasses a heterogeneous disease spectrum, complicating patient selection for conservative treatments. Cribriform architecture, a Gleason pattern 4 subtype, is associated with poorer outcomes and currently contraindicates active surveillance However, these conclusions are mainly based on retrospective data from older cohorts, raising questions about cribriform's independent prognostic value versus Gleason pattern 4 burden. Cribriform pattern correlates strongly with increased Gleason pattern 4, which is linked to adverse features such as biochemical recurrence and tumour upstaging. The independent impact of cribriform remains unclear due to limited regression analyses and variable reporting. Cribriform detection on biopsy and MRI is challenging, often leading to underestimation and complicating risk stratification. Despite current guidelines excluding cribriform-positive patients from active surveillance, emerging evidence suggests some patients with limited cribriform and low Gleason 4 percentage could be candidates for active surveillance or focal therapies. Prospective studies with standardized cribriform quantification and imaging evaluation are needed to clarify these issues.

Breast cancer can be categorised into a number of histological types, based on microscopic appearances. There is some evidence that the different breast cancer histological types are associated with different patient and tumour characteristics, but few previous studies have been large enough to investigate this systematically, especially for rare histological types. National cancer registration data were used to describe trends in the incidence of specific histological types of invasive breast cancer in women diagnosed when aged 18–89 years in England from January 1988 to December 2016, and to investigate associations between breast cancer histological types and patient and tumour characteristics. There were 838,776 women diagnosed with a first primary invasive breast cancer in this 29‐year period, including 614,698 (73%) cases of ductal carcinoma NST [no special type (NST)], 90,028 (11%) cases of lobular carcinoma, and more than 16,000 (2%) cases each of tubular and mucinous carcinomas. Rarer histological types included medullary, papillary, metaplastic, and cribriform carcinomas, with >1000 cases of each type. Data quality and completeness improved substantially during the study period. The different histological types of breast cancer showed different patterns in incidence by calendar period of diagnosis, age at diagnosis, and screen‐detection status, as well as different associations with tumour characteristics such as grade, stage at diagnosis, and molecular subtype. This large nationwide study provides an overview of the changing incidence of the different histological types of invasive breast cancer in England over almost 30 years. It also gives an opportunity to investigate the characteristics of rare histological types, which smaller studies have been unable to explore. In addition, the results demonstrate the continuing value of histological types defined by microscopic morphology, alongside newer molecular classifications.

Lymph node status of felines affected by mammary gland neoplasms: a look beyond the presence or absence of metastasis.

Nearly 12% of patients in the United States with intermediate-risk prostate cancer (PCa) opt for surveillance as their initial management strategy. Patients with aggressive histologic variants, such as cribriform and intraductal carcinoma (IDC), are considered poor candidates for surveillance. The objective of this study was to determine the sensitivity and specificity of magnetic resonance imaging (MRI)-assisted biopsy for detecting cribriform PCa and IDC. In this retrospective cohort study, patients who underwent prostate MRI before biopsy within 6 months of prostatectomy at a single institution (2018-2024) were identified. All patients had grade group 2-3 (GG2-3) PCa on biopsy. The primary outcome was the sensitivity of MRI-assisted biopsy for detecting cribriform PCa and IDC by patient in the prostatectomy specimen. The authors identified 641 patients who had 1186 tumors that were GG2-3 PCa on biopsy. The median time between MRI and biopsy was 31 days, and the median time between biopsy and surgery was 91 days. Cribriform PCa was identified in 35 patients (5.5%) at the time of biopsy and in 119 patients (18.6%) at surgery. IDC was present in 22 patients (3.4%) at biopsy and in 71 patients (11.1%) at surgery. By patient, the sensitivity for detecting cribriform PCa, IDC, or either was 21.8%, 26.8%, and 29.3%, respectively. The sensitivity by tumor for cribriform PCa, IDC, or either was 20.5%, 27.3%, and 28%, respectively. The sensitivity of MRI-assisted biopsy for detecting cribriform PCa and IDC in patients with GG2-3 PCa is poor. This work should encourage improvements in detecting variant histologies with optimized biopsy, imaging, and adjunct biomarkers.

Magnetic Resonance Imaging (MRI)-Adapted Prostate Cancer Risk Tool Incorporating Cribriform and Intraductal Carcinoma.

e13184 Background: While the overall incidence of breast cancer (BC) in the US has been increasing, the epidemiology and outcomes of specific histological subtypes of BC remain insufficiently studied. This study utilized the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the incidence, trends, and survival outcomes of different BC histologic subtypes. Methods: Data on female BC cases diagnosed between 2000 and 2021, including the subtypes: infiltrating ductal carcinoma, lobular carcinoma, metaplastic carcinoma, mucinous adenocarcinoma, papillary carcinoma, tubular adenocarcinoma, adenoid cystic carcinoma, apocrine adenocarcinoma, cribriform carcinoma, and medullary carcinoma were extracted from the SEER database. Age-adjusted incidence rates (AAIRs) and annual percent changes (APCs) were calculated using SEER*Stat v.8.4.4. The Cox proportional hazard model assessed survival outcomes adjusting for treatments including surgery, chemotherapy, and radiation using R v 4.3.2. software. Results: A total of 897,715 BC cases were identified: 765,048 infiltrating ductal carcinoma (85.1%), 90,951 lobular carcinoma (10.1%), 20,916 mucinous adenocarcinoma (2.3%), 7,905 tubular adenocarcinoma (0.9%), 3,901 metaplastic carcinoma (0.4%), 3,168 medullary carcinoma (0.4%), 2,251 apocrine adenocarcinoma (0.3%), 1,929 cribriform carcinoma (0.2%), 1803 papillary carcinoma (0.2%), and 813 adenoid cystic carcinoma (0.1%). The AAIR increased most significantly in metaplastic carcinoma (APC 3.54%, 95% CI 2.41–4.69) and lobular carcinoma (APC 1.58%, 95% CI 1.20–1.96. In contrast, the AAIR decreased the most in medullary carcinoma (APC -10.72%, 95% CI -12.18 to -9.23), followed by tubular adenocarcinoma (APC: -7.88%, 95% CI: -8.85 to -6.9). Multivariable analysis found metaplastic carcinoma had the highest mortality risk compared to infiltrating ductal carcinoma (HR 2.01, 95% CI 1.91–2.11, p &lt; 0.001) in the table. Conclusions: Metaplastic lobular carcinoma demonstrated the highest trend in annual increase in incidence and mortality, underscoring the urgent need for targeted interventions and further research in this subgroup. Additionally, while mucinous adenocarcinoma has been reported to have better survival outcomes in previous studies, our findings indicate a higher mortality risk compared to infiltrating ductal carcinoma, warranting further exploration. Multivariable analysis survival outcome of breast cancer subtypes. Subtypes aHR 95% confidence interval P value Infiltrating ductal carcinoma 1.00 (reference) Metaplastic carcinoma 2.01 1.91-2.11 &lt;0.001 Apocrine adenocarcinoma 1.28 1.20-1.37 &lt;0.001 Mucinous adenocarcinoma 1.15 1.12-1.17 &lt;0.001 Lobular carcinoma 1.10 1.08-1.11 &lt;0.001 Cribriform carcinoma 0.84 0.77-0.92 &lt;0.001 Adenoid cystic carcinoma 0.77 0.67-0.90 &lt;0.001 Medullary carcinoma 0.74 0.69-0.79 &lt;0.001 Tubular carcinoma 0.73 0.70-0.76 &lt;0.001

The term "metatypical" is anecdotally employed to describe histopathological variations that can be found in salivary gland adenoid cystic carcinoma. A 68-year-old man presented with a painful palatal nodule developed over the period of 6 months. A cone beam computed tomography showed a soft tissue-based mass with penetration into maxillary bone. An incisional biopsy was performed. The histopathology revealed a biphasic tumor predominantly composed by myoepithelial-type basaloid cells arranged in trabeculae and macrocysts with focal squamous differentiation. Occasional intervening ducts were observed. Immunohistochemical reactions highlighted the myoepithelial nature of basaloid cells, which were positive to cytokeratin 14 and smooth muscle actin, whereas the duct-forming cells were positive to cytokeratin 7 and cytokeratin 14. A small focus of conventional cribriform adenoid cystic carcinoma was identified at the periphery of the specimen. The diagnosis of metatypical adenoid cystic carcinoma was established CONCLUSIONS: The morphological diversity of metatypical adenoid cystic carcinoma represents a potential diagnostic pitfall in surgical pathology practice, particularly if the metatypical components are predominant and overlap the conventional areas. The list of differential diagnoses to be considered includes benign and malignant salivary and odontogenic tumors, but the adequate tumor classification is fundamental to ensure an appropriate treatment strategy for a long-term disease control.

Prognostic Value of Cribriform and Intraductal Carcinoma in Grade Group 2 Prostate Cancer With and Without Synchronous Nodal Metastases at Radical Prostatectomy: Results From a Case-control Matched, Multicenter Study.

Gleason Grade Group 3 Represents a Spectrum of Disease: Results from a Large Institutional Cohort.

Cribriform morular thyroid carcinoma is a rare thyroid malignancy with uncertain histogenesis. It predominantly affects young women and is strongly associated with familial adenomatous polyposis. This paper reports a rare case of sporadic cribriform morular thyroid carcinoma in a female patient in her early 50s, with somatic genetic testing revealing a KMT2C mutation. She presented with a solitary lesion confined to the right thyroid lobe and had no family history of familial adenomatous polyposis. Colonoscopy and germline genetic testing revealed no abnormalities. This finding suggests a potential link between KMT2C mutations and sporadic cribriform morular thyroid carcinoma. The clinical and imaging manifestations of this malignancy lack specificity, and the final diagnosis depends on routine pathological examination and immunohistochemical analysis. This report indicates the need for the clinical investigation of family history and genetic testing, thus contributing to the clinical realization of standardized follow-up monitoring and management.

Correlation of large cribriform carcinoma and "unfavorable histology" with other Gleason pattern 4 subtypes: A proof-of-principle study evaluating 485 radical prostatectomy specimens with proposal for the concept of "borderline histology".

P322 – The presence of intraductal carcinoma and invasive cribriform carcinoma of the prostate is not a landmark of homologous recombination repair and mismatch repair mutations in systemic treatment-naïve prostate cancer

Background: Breast carcinoma is divided into at least 21 separate histologies, according to the 2019 World Health Organization (WHO) classification. The present study is dedicated to a 5% or rarer group of all breast cancer cases. Method: In this study, we retrospectively considered the data of 4550 patients operated on for breast carcinoma at the Ankara Oncology Training and Research Hospital of the University of Health Sciences between January 2018 and February 2024. Of those cases, 401 were discovered to have rare breast cancer types. We also explored the cases by clinicopathological features, overall survival (OS), and disease-free survival (DFS). Results: Our findings revealed a total of 10 rare breast cancer types in patients explored: mucinous carcinoma, micropapillary carcinoma, papillary group carcinomas, metaplastic carcinoma, neuroendocrine carcinoma, tubular carcinoma, cribriform carcinoma, apocrine carcinoma, acinic cell carcinoma, and secretory carcinoma. While mucinous, tubular, cribriform, papillary group carcinomas, micropapillary, and secretory carcinomas are described as types associated with good prognosis, metaplastic, neuroendocrine, apocrine, and carcinomas are described as types associated with relatively poor prognosis. Conclusion: Scrutinizing the clinicopathological features of rare breast cancer types altogether may be the distinct contribution of this paper to the relevant literature and future research.

Rare histological subtypes of breast cancer introduce unique challenges to treatment and require a more personalized approach. Subtypes with favorable prognoses, such as mucinous, tubular, and cribriform carcinomas, generally respond well to less aggressive treatments such as endocrine therapy. However, certain triple-negative breast cancer subtypes that are typically considered aggressive also demonstrate unexpectedly better outcomes in specific cases. Conversely, more aggressive subtypes, including invasive micropapillary carcinoma and high-grade metaplastic breast cancer, often present greater treatment challenges due to their resistance to conventional therapies. Recent advancements in targeted treatments, such as immune checkpoint inhibitors, have shown promise in improving outcomes in some of these difficult cases. This review emphasizes the need for ongoing research and a tailored approach that considers both molecular and histological characteristics to improve the management and survival outcomes of patients with these rare and complex breast cancer subtypes.

Most lesions found in the mammary glands of cats are malignant, with aggressive behavior and unfavorable prognosis. Studies on the epidemiologic and clinicopathological characteristics of mammary lesions in cats are scarce. The present study aimed to evaluate those characteristics and to correlate them with survival in cats. Mammary specimens were selected from 418 domestic cats that underwent surgical removal with or without lymphadenectomy. The cats and mammary lesions were evaluated for epidemiologic, clinical, and pathologic characteristics. Cats with malignant neoplasms were older than cats with benign neoplasms and non-neoplastic lesions; 858 lesions were identified, including sporotrichosis, basaloid carcinoma, and benign phyllodes, described for the first time in cats. Tubulopapillary and cribriform carcinomas were the most common malignant tumors found and were very similar in characteristics such as marked anisocytosis/anisokaryosis, high mitotic count (score 3) (p < 0.001), and presence of necrosis (p = 0.005). The association between advanced age and malignancy, as well as the description of new lesions, emphasizes the importance of population studies in cats to understand the behavior of the disease and to draw attention to diagnoses that should be considered in routine care.