Microscopic mimics of prostatic carcinoma
Clear cell cribriform hyperplasia

Topic Completed: 1 June 2015

Revised: 27 February 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Clear cell cribriform hyperplasia

Andres Matoso, M.D.
Page views in 2018: 1,659
Page views in 2019 to date: 1,475
Cite this page: Matoso A. Clear cell cribriform hyperplasia. website. Accessed October 15th, 2019.
Definition / general
  • Mostly in TURP specimens of men with lower urinary tract obstruction secondary to BPH
  • Transitional zone of prostate
Prognostic factors
  • NOT a risk factor for prostate cancer
  • 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
Microscopic (histologic) 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
Microscopic (histologic) images

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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
    • 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
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