Adenoid Cystic Carcinoma — MFDS Part 1 MCQ

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ModerateOral PathologyAdenoid Cystic CarcinomaMFDS Part 1

A biopsy-proven adenoid cystic carcinoma of a minor salivary gland contains a mixture of architectural patterns. Which histological pattern is classically associated with this tumour?

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Correct answer: D — Cribriform architecture with pseudocystic spaces

The correct answer is D. Adenoid cystic carcinoma classically exhibits a cribriform or “Swiss-cheese” architecture. Tumour cells surround multiple pseudocystic spaces containing mucinous or eosinophilic basement-membrane-like material. Tubular and solid areas may coexist, so the cribriform pattern is characteristic rather than obligatory. Perineural invasion is another important feature. Reversed nuclear polarity suggests salivary gland carcinoma with reversed polarity, while papillary-cystic architecture is more associated with certain acinic cell carcinomas. Pleomorphic epithelial and myoepithelial elements in chondromyxoid stroma describe pleomorphic adenoma. Predominantly oncocytic nests instead suggest an oncocytic salivary neoplasm.

Reference: Zeng W, Li J. Molecular pathology of adenoid cystic carcinoma. Histology and Histopathology. 2025. https://pubmed.ncbi.nlm.nih.gov/71673/