Prostate
Microscopic mimics of prostatic carcinoma
Clear cell cribriform hyperplasia

Author: Andres Matoso, M.D. (see Authors page)

Revised: 22 August 2016, last major update June 2015

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Clear cell cribriform hyperplasia
Definition / General
Epidemiology
  • Mostly in TURP specimens of men with lower urinary tract obstruction secondary to BPH
Sites
  • Transitional zone of prostate
Prognostic Factors
  • NOT a risk factor for prostate cancer
Treatment
  • Similar to BPH
Gross Description
  • Same as BPH
  • On cross section, there is nodular expansion of periurethral area with compression of posterior lobes and urethra
Micro Description
  • Numerous cribriform glands arranged in a nodular fashion with variable intervening stroma
  • Epithelial cells have a distinctive clear cytoplasm and small nuclei with inconspicuous or small nucleoli
  • Basal cells may be invisible in some glands, very prominent in others or form small knots to the side
Micro Images

Images hosted on other servers:

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Glands are arranged in lobules and have sieve-like cribriform architecture

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Glandular clusters have punched out lumens

Positive Stains
Molecular / Cytogenetics Description
  • Flow cytometric studies performed on 13 cases of cribriform clear cell hyperplasia showed diploid DNA in all cases (Am J Clin Pathol 1991;95:446)
Differential Diagnosis
  • Clear cell cribriform hyperplasia is considered a mimicker of adenocarcinoma of the prostate with Gleason score 7 or higher
    • Due to the cribriform pattern, it can be confused with Gleason score 4+4=8 prostate cancer
    • The bland cytology and presence of basal cells in some glands in cribriform clear cell hyperplasia rules out carcinoma
  • HGPIN
    • Clear cribriform hyperplasia may show basal cells with nucleoli while the luminal cells have small nuclei without nucleoli
    • In contrast, the luminal cells of high grade PIN show prominent nucleoli