An Analysis of Configuration of Lateral Lamella of Cribriform Plate of Ethmoid: A Computed Tomographic Study.

Background: Ethmoid Skull Base (ESB) is anarticulation of ethmoid roof with Lateral Lamella ofCribriform plate (LLCP). An increased LLCP heightwas observed to increase the vulnerability of ESB tosurgical injuries. Aim and Objectives: The present studywas undertaken to analyze the configuration of thelateral lamella of cribriform plate, the ethmoid roof withrespect to Keros type of olfactory fossa. Material andMethods: Aretrospective Computed Tomographic (CT)study was done with 60 Coronal Paranasal Sinuses(PNS) scans and LLCP height was determined bysubtracting Medial Ethmoid Roof Point (MERP) fromCP heights and classified according to Keros. Thedifference between Medial Ethmoid Roof Point(MERP) and Lateral Ethmoid Roof Point (LERP)heights in both anterior and posterior planes indicatesthe direction of ethmoid roof slope. Results: Theaverage height of the LLCP was between 1.53 to 8.55mm with a mean (SD) of 3.77 mm 1.66 and majoritybelonged to Keros type I. Overall mean differencebetween LERP and MERP was 5.43 0.74 mm inanterior and 4.43 0.63 mm in posterior planes. In boththe planes irrespective of the sides the height of theLERPwas higher in relation to medial side. Conclusion:Keros type I was the most common type and the slope ofanterior ethmoid roof is steeper compared to posterior.This preoperative knowledge about the configuration ofLLCPas well as the ethmoid roof contour is vital duringendonasal ethmoidal surgeries.

Progress in Research on the Cribriform Component in Lung Adenocarcinoma / 中国肺癌杂志

The morbidity of lung cancer ranks top in the world. At present, lung adenocarcinoma (LUAD) is the most common histologic type of lung cancer. However, the prognoses of LUAD patients with the same subtype remain heterogeneous. Histological heterogeneity is one of the main causes of diverse prognoses of patients with LUAD. Studies have shown that there are other histologic patterns that affect the clinical outcomes of LUAD patients, in addition to the five growth patterns of invasive LUAD classified by the World Health Organization (WHO) in 2015. The cribriform component (CC) is one of the research hotspots among histopathology of LUAD. Previous studies have shown that the presence of CC can further stratify the prognoses of patients with LUAD. Along with the progressively deep insights into the aforementioned topic, researchers are dedicating to unveiling the relationships among CC and and other clinicopathological factors as well as their joint influence on the survival of LUAD patients. The review manages to generalize the latest research progress in the CC in LUAD patients.

Intraductal Carcinoma of Salivary Gland Originating from an Intraparotid Lymph Node: A Case Report

@#Introduction: Salivary gland intraductal carcinoma (IDC) is rare. We present the second case of IDC originating from an intraparotid lymph node (LN) with a more detailed description of the histogenesis, immunohistochemistry (IHC) and updated molecular information. Case Report: An 87-year-old male had a tumour nodule over the left parotid tail for about 20 years. Physical examinations revealed a 4.5 cm soft, non-tender and fixed mass. After the left parotidectomy, pathology confirmed the diagnosis of IDC arising within an intraparotid lymph node. The cystic component of the tumour was lined by single to multilayered ductal cells with micropapillary growth pattern. The solid part showed intraductal proliferation of neoplastic cells in solid, cribriform, micropapillary and Roman bridge-like structure. By immunohistochemistry (IHC), the tumour cells were positive for S-100, CK (AE1/AE3), mammaglobin, SOX10, and estrogen receptor (ER), with myoepithelial cell rimming highlighted by positive p63 and calponin IHC stains. The prognosis of this patient is excellent after complete excision. Discussion: The mechanism of salivary gland tumour arising in the intra-parotid gland LN was assumed to be related to salivary duct inclusion within the intraparotid gland LN which is a normal occurrence during embryology development. Although the terminology may raise some confusion about the relationship between IDC and conventional salivary duct carcinoma (SDA), they are different in immunophenotype and clinicopathologic features. IDC is characterised by S100 (+) ER (+) with predominant intraductal growth and excellent prognosis; while SDC features S100 (-) androgen receptor (+) with predominant invasive growth and aggressive behavior. Recent discovery of recurrent RET gene rearrangement in IDC but not SDC also supports that IDC is not precursor lesion of the SDC.

Cytohistology of morule in cribriform-morular variant of papillary thyroid carcinoma

@#Introduction: Cribriform-morular variant (CMV) is a rare variant of papillary thyroid carcinoma. It frequently occurs in association with familial adenomatous polyposis (FAP), although some cases are sporadic. Herein, we report a case of CMV and analyse morule cytohistology. Case Report: The patient was a 47-year-old woman with no familial history of FAP. A 3.0-cm unifocal mass was identified in the left thyroidal lobe. Fine-needle aspiration cytology revealed papillary clusters of atypical cells with nuclear grooves, which was suspected to be conventional papillary thyroid carcinoma. Histologically, the tumour comprised a papillary and cribriform growth of atypical cells with cytoplasmic accumulation and nuclear translocation of b-catenin. In addition, frequent morule formation was identified. Discussion: In this case, we performed morule analysis through correlative light and electron microscopy (CLEM), and revealed its ultrastructure. Although CMV is a rare form of thyroid carcinoma, it should be considered along with its distinct clinicopathological characteristics.

A Novel Adenomatous Polyposis Coli Gene Mutation of Cribriform-Morular Variant Papillary Thyroid Carcinoma: A Case Report / 대한이비인후과학회지

Cribriform-morular variant papillary thyroid carcinoma (CMV-PTC) is a rare cancer that may arise in patients with familial adenomatous polyposis (FAP). Adenomatous polyposis coli (APC) gene mutation is associated with FAP, which is known as a premalignant lesion of colon cancer. In this report, we report a 16 years old patient of CMV-PTC comorbid with FAP, which was related with a new type of APC gene mutation.

Primary cutaneous cribriform apocrine carcinoma: Case report and literature review

Primary cutaneous cribriform apocrine carcinoma is a rare but distinct variant of primary cutaneous apocrine carcinoma and it is considered a low grade malignancy. We herein present a case of primary cutaneous cribriform apocrine carcinoma at the neck of a 26-year-old female. The tumor features a relatively well-circumscribed border and multiple aggregations of mildly pleomorphic epithelial cells with large ovoid nuclei, small nucleoli and abundant eosinophilic cytoplasms. Cribriform and tubular structures are the major architectural patterns. The primary differential diagnosis is cutaneous metastasis from a cribriform visceral carcinoma; others include primary secretory carcinoma of the skin, adenoid cystic basal cell carcinoma and primary cutaneous adenoid cystic carcinoma.

Clinicopathologic and molecular features of cribriform morular variant of papillary thyroid carcinoma / 中华病理学杂志

Objective@#To investigate the clinicopathologic and molecular features of the rare cribriform morular variant of papillary thyroid carcinoma (CMV-PTC).@*Methods@#The clinicopathologic data of 10 patients with CMV-PTC were retrospectively reviewed. Immunohistochemical (IHC) staining was done using LSAB method. DNA sequencing for APC were applied using Sanger method. BRAF V600E mutation was examined using ARMS method. The cytological, morphological, IHC and molecular features were analyzed.@*Results@#All patients were female at an average age of 27 years old. The tumors were mostly located in the right lobe of thyroid. Fine needle aspiration cytology was performed in three patients; two were diagnosed as suspicious for PTC and one as PTC. Nine tumors presented as solitary nodule and two as multiple nodules in both lobes. Infiltration was demonstrated in three cases. The average size was 2.6 cm. The neoplastic cells were arranged in papillary, cribriform, solid and glandular patterns, with rare or without colloid inside the lumen. The number of morula varied, ranging from zero to many. The neoplastic cells were variably enlarged, showing round, oval or spindle shape. Nuclear irregularity was identified as irregular membrane, nuclear grooves or pseudoinclusion, but no typical ground glass feature. Peculiar nuclear clearing could be observed in the morular cells. IHC staining showed the neoplastic cells were negative for thyroglobulin and p63, but positive for TTF1, cytokeratin 19 and estrogen receptor. Diffuse staining with cytokeratin was seen in the neoplastic cells and the morula. Specific cytoplasmic and nuclear staining of β-catenin was seen in the neoplastic cells but not the morula. Ki-67 proliferation index was 1%-30%. No recurrence or metastasis was observed. One patient was demonstrated to harbor both somatic and germline mutations of the APC gene, who was found to have adenomatous polyposis and her mother died of colonic carcinoma. No BRAF V600E mutation was detected.@*Conclusions@#CMV-PTC is rare and shows atypical cytological and clinicopathological features, and it is easily misdiagnosed.TG, TTF1, ER and β-catenin are specific IHC markers for CMV-PTC. The morula is negative for cytokeratin 19, in contrast to squamous metaplasia. Although CMV-PTC has indolent clinical behavior, a definite diagnosis is necessary to rule out the possibility of APC gene mutation and related extra-thyroidal neoplasm, such as FAP and Gardner syndrome.

Progressive Cribriform and Zosteriform Hyperpigmentation: A Case Series and Review of the Literature / 대한피부과학회지

Progressive cribriform and zosteriform hyperpigmentation (PCZH) is a distinctive pigmentary disorder observed along the lines of Blaschko. Clinically, the lesions appear as uniformly tan, cribriform macular hyperpigmentation with a zosteriform distribution, without a history of rash, injury, inflammation, or other associated cutaneous or internal abnormalities. Histopathological specimens show increased melanin pigmentation in the basal cell layer with a complete absence of nevus cells. We report 8 cases of PCZH and review the literature on this peculiar disorder.

Clinical presentation and MRI findings in invasive cribriform carcinoma of the breast / 实用放射学杂志

Objective To analyze MRI features of invasive cribriform carcinoma of the breast,and to improve the diagnostic accuracy of the disease.Methods MRI of 10 cases with biopsy-proved invasive cribriform carcinoma of the breast in our hospital were analyzed retrospectively.Results 10 cases with invasive cribriform carcinoma of the breast showed unclear boundary.Lesions showed isointensity on T1 WI,and hyperintensity on T2 WI partially with point-like low signal intensity.After contrast administration,the lesions showed heterogeneous enhancement,most of which showed point-like low signal intensity in the lesions,which may be the characteristic manifestations of invasive cribriform carcinoma of the breast.The patterns of time-signal intensity curves were washout type and platform type.Five cases had lymph node metastasis,which may due to the overexpression of PR.Conclusion MRI plays an important role in the diagnosis of invasive cribriform carcinoma of the breast.There is a promising benefit of this radiation-free technique for selecting the optimal therapeutic regimen for this disease.

Olfactory neuroblastoma

@#This 57 year-old woman presented with a seizure. She had a history of attending the ENT and neurosurgical departments for more than a decade. At the time of her initial presentation many years prior, her main complaint was of nasal congestion. A nasopharyngeal biopsy confirmed an olfactory neuroblastoma. Olfactory neuroblastoma is an uncommon slow growing tumour of the nasal cavity with no established etiological basis. With a neuroectodermal origin, it arises from the olfactory epithelium of the upper nasal cavity.1 Most cases arise from the cribriform plate, upper third of the nasal septum, superior turbinates or anterior ethmoidal air cells. However, it typically presents late when multiple structures are involved, which may include the orbits and intracranial compartments.2 Accounting for approximately 2% of sinonasal tumors, although often late to present, ironically only a minority of patients experience anosmia.3 The commonest complaint at initial presentation is nasal blockage accounting for nearly a quarter of cases, with headache and epistaxis the next most frequent symptoms.1 Multi-modality imaging is essential in that the most recognized management of this infrequent tumor is a combination of craniofacial surgery and radiotherapy. The imaging pathway in this case was typical, with CT and MRI complementing each other in maximizing tumor delineation. Computed Tomography has superior definition is reviewing bony involvement which is a typical finding, whereas MRI has superiority in evaluating the extent of soft tissue invasion and establishing tumor boundaries against post obstruction fluid in the paranasal sinuses.3 In this case the CT illustrates the gross destruction of the skull base, orbital and sinus margins. (Figure 1-4) The MRI outlines the extension of disease involving the pituitary fossa, brainstem and frontal sinus invasion. (Figures 5 and 6)

Low-grade cribriform cystadenocarcinoma of the parotid gland

@#This is the case of a 44-year-old woman with a one-year history of a left pre-auricular mass. The surgical specimen is a 5 centimeter diameter tan-brown irregularly-shaped tissue whose cut surfaces are brown with cystic spaces. Microscopic sections show cystic and dilated ductal spaces lined by cells forming irregular, variably-sized secondary spaces. These spaces are arranged in a cribriform pattern that is reminiscent of breast ductal hyperplasia. (Figure 1) The ductal cells lining the spaces are small, multilayered, and generally bland. The superficial cells show apocrine-type cytoplasmic snouting. There is no significant nuclear atypia or mitotic activity noted. Necrosis is also absent. (Figure 2) Based on these features, we signed the case as a low-grade cribriform cyastadenocarcinoma (LGCCC).

Correlation of clinicopathological features and prognosis in patients with colorectal cribriform comedo-type adenocarcinoma / 临床与实验病理学杂志

Purpose To investigate the clinicopathological features and prognosis in patients with colorectal cribriform comedo-type ad-enocarcinoma. Methods Compared with 278 cases of colorectal common-type adenocarcinoma, 24 cases of colorectal cribriform come-do-type adenocarcinoma were analyzed for clinical stage, lymphovascular invasion, lymph node metastasis and genetic characteristics. Results The percentage of clinical Ⅲ and Ⅳ (87. 5%) and lymph node metastasis rate (87. 5%) in patients with colorectal cribri-form comedo-type adenocarcinoma was obviously higher than that in colorectal common-type adenocarcinoma (42. 4%,42. 4%) (P0. 05 ) . Conclusions There is a higher clinical stage and poorer prognosis including unique morphological characteristics, highly lymphovascular invasion and lymph node metastasis in pa-tients with colorectal cribriform comedo-type adenocarcinoma.

Clinicopathologic features and immunohistochemical staining of basal cell adenoma with a fo-cal cribriform pattern in salivary gland / 临床与实验病理学杂志

Purpose To study the clinicopathologic features and immunophenotype of the basal cell adenoma ( BCA) with a focal crib-riform pattern in salivary gland. Methods Four cases of BCA with a focal cribriform pattern were retrospectively analyzed with their clinical findings, histopathology and immunohistochemical staining for CK, CK14, CK8/18, CK19, EMA, CD10, CD117, BCL-2, CDX-2, SMA, S-100, p63, p53, EGFR and Ki-67. Results Four cases of BCA with a focal cribriform structure all appeared as slow-growing neoplasms with good circumscription and lack of infiltrative properties, with capsular invasion but without capsular break-through. There are have at least a 50% area of cribriform structure in tumors under microscope. Immunohistochemical profiles exhibi-ted weak positivity for CK, EMA, CD10, CD117, BCL-2, CDX-2, p53 and EGFR, moderate for CK14, CK8/18, SMA and S-100, and strong for CK19, p63 and Ki-67 index<1%. Conclusions Cribriform type of salivary bacal cell adenoma is relatively rare and has difficulty in distinction from adenoid cystic carcinoma ( ACC) . Clinicopathologic features and immunophenotype are the most relia-ble points for differential diagnosis of BCA from ACC.

Cutaneous Leishmaniasis Mimicking Pyoderma Gangrenosum.

Cutaneous leishmaniasis (CL) is caused by leishmania, a single-called parasite and is transmitted the bite of sand fly. It characterized by ulcers, which are usually without pain or pruritus. Both old world and new world species cause localized CL. Old world disease begins as a small erythematous papule at the site of the bite of the sand fly and over several weeks it enlarges up to 3 cm eventually becoming eroded and crusted. After lasting for several months the ulcer heals with a slightly depressed scar. We report the case of a 27-year-old man native of South India, carpenter by occupation, working in Saudi Arabia for >5 years who presented with a painful ulcer of 10 cm in diameter over his right shoulder with purulent discharge. He was diagnosed to have CL and was treated with intramuscular injection of sodium stibogluconate 20 mg/kg/day for 30 days. The resultant cribriform scar resembled that of pyoderma gangrenosum.

Cribriform-Morular Variant of Papillary Thyroid Carcinoma Associated with Familial Adenomatous Polyposis / 대한이비인후과학회지

We report a case of cribriform-morular variant of papillary thyroid carcinoma associated with familial adenomatous polyposis. A 21-year-old woman presented with multiple, well-defined, oval shaped thyroid nodules, which showed hypo-echoic and solid mixed with some cystic components by ultrasound, and poorly enhancing and low dense by CT scan. Cytological finding was compatible with papillary carcinoma. Total thyroidectomy was performed and nodules were palated soft. Histologic analysis confirmed the diagnosis of cribriform-morular variant of papillary thyroid carcinoma. Familial adenomatous polyposis, thereafter, was diagnosed by family history and colonoscopy, and preventive colectomy was performed.

A Case of Progressive Cribriform and Zosteriform Hyperpigmentation / 대한피부과학회지

Progressive cribriform and zosteriform hyperpigmentation (PCZH) is a distinctive syndrome first described by Rower et al. in 1978. It characteristically presents as a single area of uniformly tan, cribriform macular pigmentation with zosteriform distribution. Further, it can histologically be characterized by increased melanin pigmentation in the basal cell layer with a complete absence of nevus cells, and a lack of a preceding history of skin rash, injury or inflammation or other associated cutaneous or internal abnormalities. We herein report a case of PCZH that had developed along the right abdomen, right flank area and right back area in a 26-year-old male. The histologic investigation revealed increased melanin pigmentation in the basal layer and a distinct lack of nevus cells.

Cytomorphological Findings and Histological Correlation of Low-Grade Cribriform Cystadenocarcinoma of Salivary Gland in Fine-Needle Aspiration: A Case Study

Low-grade cribriform cystadenocarcinoma (LGCCC) of the salivary gland is a rare tumor. We report the cytologic features and histologic correlation of a patient with LGCCC. A 57-year-old man had a hardly palpable, nontender mass in the right cheek area followed over nine months. Radiologic analysis revealed a 1.2 cm multiseptated, cystic, solid nodule in an anterior superficial lobe of the right parotid gland. Fine-needle aspiration cytology revealed many irregular overlapping sheets or clusters of ductal epithelial cells forming solid, pseudopapillary, and cribriform architectures. Nuclei of the tumor cells revealed inconspicuous atypia with minimal size variation. On the basis of these findings, we confirmed a diagnosis of ductal epithelial proliferative lesion, favoring neoplasm, with uncertain malignant potential. Tumor excision was performed, revealing a tiny multicystic nodule (0.7 cm). Histopathologically, this tumor showed the characteristic morphology of LGCCC. This is the first report of cytomorphological findings of LGCCC in Korea.

Fine-Needle Aspiration Cytology of Low-Grade Cribriform Cystadenocarcinoma with Many Psammoma Bodies of the Salivary Gland

Low-grade cribriform cystadenocarcinoma (LGCCC) is a rare salivary gland tumor that was recently defined as a variant of cystadenocarcinoma by the 2005 World Health Orgazniation (WHO) classification system. We report cytologic findings of an unusual case of LGCCC with many psammoma bodies. A 90-year-old man presented a palpable mass on his left parotid gland. Fine-needle aspiration (FNA) cytology showed tumor cells that were arranged in clusters and dispersed individually. The tumor cells showed mild atypia and had clear or dense cytoplasm with some vacuoles. Numerous psammoma bodies were noted. After surgical resection, the histologic examination revealed a mixed solid and cystic mass showing intraductal growth with focal stromal invasion. The S-100 protein expressed in the tumor cells, but smooth muscle actin and p63 were positive only in myoepithelial cells. Although LGCCCs resemble other salivary gland tumors, differentiating LGCCC during preoperative FNA is important to avoid unnecessary overtreatment.

Invasive Cribriform Carcinoma Arising in Malignant Phyllodes Tumor of Breast: A Case Report

Phyllodes tumor is an uncommon fibroepithelial neoplasm of the breast. And it is characterized by expanded stroma with increased cellularity and elongated epithelium-lined clefts. Mammary carcinomas within phyllodes tumors have been rarely reported. To date, however, no reports have described the invasive cribriform carcinoma arising in malignant phyllodes tumor. Here, we report a 62-year-old woman who presented with a large breast mass. Microscopically, the mass was a typical malignant phyllodes tumor showing well developed leaf-like architecture and stromal overgrowth with high cellularity and nuclear pleomorphism. In a portion of the tumor, however, the epithelial component showed a cribriform pattern of proliferation in the absence of myoepithelial cells, suggestive of the invasive cribriform carcinoma. To our knowledge, this is rare and it is difficult to make a differential diagnosis of it. Here, we report our case with a review of literatures.

Linear Hyperpigmentation Along the Blaschko's Line: A Clinicopathologic Study / 대한피부과학회지

BACKGROUND: Many pigmentary disorders can be manifested as linear streaks of hyperpigmentation, along the Blaschko's line. These include progressive cribriform and zosteriform hyperpigmentation (PCZH) and linear and whorled nevoid hyperpigmentation (LWNH). There have been debates on the universally accepted diagnostic criteria differentiating these disease entities. OBJECTIVE: To determine the clinicopathologic characteristics of hyperpigmentation along the line of Blaschko and to examine the acceptability of PCZH or LWNH criteria as a diagnostic tool for differentiating these diseases. METHODS: A retrospective study was conducted on 13 patients who presented with linear hyperpigmentation along the Blaschko's line. The patients' clinicopathologic characteristics were analyzed and matched with the PCZH/LWNH diagnostic criteria. RESULTS: Age of onset widely ranged from birth to 61 years, but predominantly before the age of 4 years. The male-female ratio was 1:1.2. Trunk was the most common site of involvement. Histologic examination commonly showed a basal layer hyperpigmentation in all patients and pigmentary incontinence was observed in 2 patients. Four patients who satisfied all the diagnostic criteria for PCZH also fulfilled the diagnostic criteria for LWNH, except for the timing of onset. An additional 4 patients satisfied all the diagnostic criteria for LWNH and also fulfilled the diagnostic criteria for PCZH, except for the timing of onset. Excluding the age of onset criteria, the other 3 patients fulfilled both diagnostic criteria for PCZH and LWNH. CONCLUSION: These results demonstrate that PCZH and LWNH should not be considered as a different disease entity and that supports the idea that these are part of the same disease spectrum.