Predictors of outcome in the phenotypic spectrum of polymorphous low-grade adenocarcinoma (PLGA) and cribriform adenocarcinoma of salivary gland (CASG): A retrospective study of 69 patients Journal Article


Authors: Xu, B.; Aneja, A.; Ghossein, R.; Katabi, N.
Article Title: Predictors of outcome in the phenotypic spectrum of polymorphous low-grade adenocarcinoma (PLGA) and cribriform adenocarcinoma of salivary gland (CASG): A retrospective study of 69 patients
Abstract: Polymorphous low-grade adenocarcinoma (PLGA) shows histologic diversity with fascicular and targetoid features while cribriform adenocarcinoma of salivary gland (CASG) demonstrates predominant cribriform and solid patterns with glomeruloid appearance and optical clear nuclei. The current study is designed to identify pathologic features that may predict clinical outcome in 69 PLGA/CASG. Seven patients had recurrences or distant metastasis, including 3 local recurrences, 2 nodal metastases, and 2 distant metastases. The following histologic factors predicted disease-free survival on univariate analysis: tumor size, bone invasion, lymphovascular invasion, tumor necrosis, ≥10% papillary pattern, and ≥30% cribriform pattern. On multivariate analysis, 10% of papillary pattern and 30% cribriform pattern were independent prognostic factors of disease-free survival. Histologic classification of the 69 tumors (based on the prior reported definition of CASG) showed 21 CASGs (30%), 23 PLGAs (33%), and 22 (32%) with indeterminate features of PLGA and CASG. In addition, 3 (4%) tumors demonstrated a predominant papillary pattern (≥50%). Interestingly, not all CASGs were located in the minor salivary gland and 2 tumors were identified in the parotid. One patient died from her disease and she harbored a CASG with >30% cribriform pattern. In conclusion, tumor size, bone invasion, and lymphovascular invasion are significant parameters that can predict adverse clinical behaviors in PLGA/CASG on univariate analysis. Using the prior reported definition, an overlapping histology between PLGA and CASG was noted in over a third of the cases. Regardless of tumor subclassification, the percentage of cribriform and papillary patterns seems to be prognostically relevant and should be documented. © 2016 Wolters Kluwer Health, Inc.
Keywords: immunohistochemistry; histology; prognosis; cribriform adenocarcinoma of salivary gland (casg); polymorphous low-grade adenocarcinoma (plga)
Journal Title: American Journal of Surgical Pathology
Volume: 40
Issue: 11
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2016-11-01
Start Page: 1526
End Page: 1537
Language: English
DOI: 10.1097/pas.0000000000000705
PROVIDER: scopus
PMCID: PMC5069130
PUBMED: 27454943
DOI/URL:
Notes: Article -- Export Date: 6 December 2016 -- Source: Scopus
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MSK Authors
  1. Ronald A Ghossein
    483 Ghossein
  2. Nora Katabi
    304 Katabi
  3. Bin   Xu
    227 Xu
  4. Amandeep   Aneja
    5 Aneja