24 May 2007 – Case of the Week #85
These cases can also be accessed by clicking on the Case of the Week button on the left hand side of our Home Page at www.PathologyOutlines.com. This email is sent only to subscribers. To view the images or references, you must click on the links in blue.
To subscribe or unsubscribe, email [email protected], indicating subscribe or unsubscribe to Case of the Week. We do not sell, share or use your email address for any other purpose. We also have emails for Pathologist jobs (biweekly), Other Laboratory jobs (biweekly), website news (monthly), new books (monthly), and a newsletter (twice a year). You must subscribe or unsubscribe separately to these email lists.
Sign up for our new Books email by emailing [email protected] with “subscribe to new books email” in the subject line. Every month, we will send you a list of new pathology related books with a short summary and link to Amazon.com and the publisher for further information. The email is free, and you can unsubscribe at any time.
We thank Dr. Ankur Sangoi, Stanford University, Stanford, California (USA) for contributing this case. We invite you to contribute a Case of the Week by emailing [email protected] with microscopic images (any size, we will shrink if necessary) in JPG or TIFF format, a clinical history, your diagnosis and any other images (gross, immunostains, etc.) that may be helpful or interesting. We will write the discussion (unless you want to), list you as the contributor, and send you a check for $35 (US dollars) for your time after we send out the case. Please only send cases with a definitive diagnosis.
Case of the Week #85
A 66 year old man had a prostate biopsy showing adenocarcinoma (Gleason 3+3) in 1 of 12 cores. He had a radical prostatectomy.
What is your diagnosis?
Bilateral seminal vesicle amyloidosis
Amyloidosis commonly occurs in the seminal vesicles of men. The incidence increases with age, reaching 21% in men age 75 years and older (Histopathology 1993;22:173, Am J Pathol 1983;110:64). At this site, it is usually a localized finding, and not part of a systemic process. Although immunohistochemistry often detects lactoferrin within the deposits (Ann Pathol 2004;24:236), a recent study suggests that the amyloid derives from semenogelin I, the major secretory product of the seminal vesicles (J Lab Clin Med 2005;145:187). Semenogelin I and II are mainly responsible for immediate gel formation of freshly ejaculated semen, and are degraded by the proteolytic action of prostate specific antigen/PSA (J Androl 1996;17:17, free full text)
The case contributor notes that trichrome is useful in detecting amyloid. It stains the amyloid a dusky gray, in sharp contrast to the strong blue staining of collagen. This is an alternate to Congo Red staining and polarization, which often does not work well.
Nat Pernick, M.D., President
30100 Telegraph Road, Suite 404
Bingham Farms, Michigan (USA) 48025
Email: [email protected]