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Adenoid Cystic CA : Microscopic

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Adenoid cystic carcinoma shows an admixture of many architectural patterns, including cribriform, tubular, and solid growth with a myxohyaline stroma. There are two cell types – abundant basaloid cells with myoepithelial differentiation and eosinophilic epithelial cells with ductal differentiation.

The cribriform areas are almost always present, even if focally. They consist of variable-sized, smooth contoured lobules or islands of uniform basaloid cells punctuated by round rigid gland-like spaces. These spaces are not true glandular lumens but represent stromal invaginations (pseudocysts). They are filled with eosinophilic material (PAS-positive, diastase-resistant; reduplicated basal lamina) or basophilic myxoid mucinous material (Alcian blue positive). True glandular structures lined by low cuboidal cells with eosinophilic cytoplasm are also present.

Image courtesy of: @Patholwalker

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