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Prostate

Microscopic mimics of prostatic carcinoma

Seminal vesicles / ejaculatory duct


Reviewers: Komal Arora, M.D., (see Reviewers page)
Revised: 26 July 2012, last major update July 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Small glandular diverticula from central seminal vesicle lumen resemble carcinoma
● Epithelial lining of ejaculatory ducts is similar to seminal vesicles

Micro description
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● Seminal vesicle has thick muscular wall, complex mucosal folds, columnar and basal cells
● Cytoplasm has large coarse golden yellow/brown lipofuscin/lipochrome granules (finer granules present in normal prostate gland)
● Columnar cells also have atypical appearing “monster” cells with prominent nuclear atypia and degenerative appearance, may contain hyaline globules (degenerative) (Am J Surg Pathol 1981;5:483)
● Lipochrome pigment granules may be type 1 (coarse, golden yellow-brown, usually abundant, usually in seminal vesicle/ejaculatory duct epithelium) or type 2 (fine, gray-brown, or dark and scant, present in occasional prostate adenocarcinomas or normal prostate acini, Arch Pathol Lab Med 1999;123:1093, Hum Pathol 1995;26:1302
)
● Crystalloid type secretions common, although usually multiple, curved edges, varied forms (elliptical, cylindrical, rodlike, and rectangular); not associated with malignancy (Arch Pathol Lab Med 2001;125:141)
● No mitotic activity, no nucleoli
● Note: significant lipochrome also found in central zone prostatic epithelium; lesser amounts in peripheral and transition zones, occasionally in nodular hyperplasia, high grade PIN, adenocarcinoma

Micro images
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Various images

Positive stains
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● MUC6 and nuclear PAX2 immunoreactivity is typical in epithelium of seminal vesicle and ejaculatory duct (Hum Pathol 2010;41:1145)

Negative stains
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● PSA (may be focal or weak positive)

Molecular description
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● Normal seminal vesicles may be aneuploid (Mod Pathol 1991;4:687)

Differential diagnosis
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● Adenocarcinoma (MUC6-, Am J Surg Pathol 2003;27:519)

End of Prostate > Microscopic mimics of prostatic carcinoma > Seminal vesicles / ejaculatory duct


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