1. Overall low power appearance |
Necrotic debris in the background |
Abundant detached atypical cells in the necrotic debris or clot |
Numerous sheets of atypical cells |
2. Structural atypia/abnormalities |
Irregular contour (ex. cribriform pattern) |
Lack of uniformity of glandular formation |
Luminal necrosis |
3. Cellular atypia |
Enlarged nuclei |
Irregular nuclear contour |
Prominent nucleoli |
Hyperchromatism |
Anisonucleosis 4:1 within a single duct |
Morphological heterogeneity of intracellular mucus |
Easily identifiable mitotic figures |
Clear or foamy cell change in the cytoplasm |
4. Parenchymal invasion |
Haphazard (or irregular) arrangement of glands |
Stromal desmoplasia |