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Prostate

Microscopic mimics of prostatic carcinoma

Mesonephric remnants / hyperplasia


Reviewers: Komal Arora, M.D., (see Reviewers page)
Revised: 3 May 2012, last major update May 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Rare, <1% of TURP specimens (Mod Pathol 2003;16:630)

Mesonephric ducts:
● Embryonic structures eventually replaced by metanephric ducts to form the permanent kidney
● Play a critical role in development of functional urinary system and male reproductive system, including the ureter, renal pelvis, collecting tubules, ejaculatory ducts, seminal vesicles, vas (ductus) deferens
● Embryonic vestiges (mesonephric remnants) may persist
● Located in prostate base and periprostatic soft tissue
● Resembles mesonephric hyperplasia in female genital tract

Micro description
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● Proliferation of round to oval tubules/acini lined by benign cuboidal to low columnar epithelium, ranging from lobular aggregates of microacini to dilated structures containing characteristic colloid-like material
● Prominent nucleoli
● Cells have scant to moderate cytoplasm and inconspicuous small nucleoli
● Infiltrative growth between smooth muscle bundles without stromal desmoplasia

Micro images
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Various images


Fig A: glands infiltrate between smooth muscle bundles and prostatic gland
Fig B: atypical small acinar proliferation with atypia and nucleoli
Fig C: confirmed as mesonephric remnants by high molecular weight CK positivity of basal cell layer of normal gland and focal staining of atypical small glands; also diffuse p63 expression (fig D) and ication 200), and absence of p504S staining (fig E)
Fig F: diffuse staining for androgen receptor


Positive stains
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● CK903 (Am J Surg Pathol 1993;17:454), PAX8 (Am J Surg Pathol 2011;35:1054), P504S (focal +)

Negative stains
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● PSA, PAP, p63

End of Prostate > Microscopic mimics of prostatic carcinoma > Mesonephric remnants / hyperplasia


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