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Adenoid Cystic CA : Solid Pattern

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Adenoid cystic carcinoma shows an admixture of many architectural patterns, including cribriform, tubular, and solid growth with a myxohyaline stroma.

The solid pattern consists of sheets, islands, or large solid nests of closely packed basaloid cells with little or no intervening hyaline stroma. True glandular lumens are rare in solid areas. Nuclear pleomorphism, increased mitotic activity and necrosis may be present.

Grade 1 can have no solid areas. Grade 2 tumors can have <30% solid foci. Grade 3 tumors have >30% solid areas.

The solid pattern is associated with larger tumor size, earlier and more frequent recurrences, greater likelihood of metastasis, and earlier fatal outcome. Image courtesy of: @Patholwalker

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