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. 2021 Apr 9;11:647172. doi: 10.3389/fonc.2021.647172

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Copyright © 2021 Zhu, Zhu, Xue, Zhang, Hu, Liu and Lu

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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(A) Classic high-grade transformation (HGT) features, including severe nuclear atypia, desmoplastic stroma, and irregular solid nests (100×). (B) Absence of p63 staining in HGT components compared with positive staining in a few cribriform-tubular structures within the same microscope field (100×). (C) Non-classical HGT features include moderate nuclear atypia, myxoid/hyaline matrix, and more regular solid nests (100×). (D) Obvious incomplete p63 staining in a non-classic HGT case (100×). (E) Conventional grade III ACC usually presents as mixed cribriform and solid patterns (100×). (F) The p63 stained basal/myoepithelial cell layer was still within the mixed architecture of conventional grade III ACC (100×).