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Microscopic mimics of prostatic carcinoma

Xanthoma cells

Reviewers: Komal Arora, M.D., (see Reviewers page)
Revised: 22 May 2014, last major update June 2012
Copyright: (c) 2003-2014, PathologyOutlines.com, Inc.


● Seen in xanthoma or xanthogranulomatous prostatitis
● Localized collection of cholesterol-laden histiocytes, usually idiopathic, may be seen in patients with hyperlipidemia
● May be interpreted as Gleason 4-hypernephroid pattern or clear cell adenocarcinoma, particularly in needle biopsies (Hum Pathol 1994;25:386)

Micro description

● Abundant vacuolated foamy cytoplasm; small, uniform, benign appearing nuclei, small inconspicuous nucleoli
● May have infiltration of prostatic stroma by cords and individual cells (Am J Surg Pathol 2007;31:1225)
● No mitoses, rare/no necrosis

Micro images

Various images


Positive stains

● CD68

Negative stains

● CAM5.2

Differential diagnosis

Foamy gland carcinoma: crowded or infiltrative glands with abundant foamy cytoplasm, frequently ppink acellular secretions
Hypernephroid adenocarcinoma: Gleason pattern 4(c); nests of clear cells resembling renal cell carcinoma; small, hyperchromatic nuclei; fusion of acini into more solid sheets with the appearance of back to back glands without intervening stroma
Pseudohyperplastic carcinoma with xanthomatous changes: nests of medium to large glands resembling hyperplastic nodules; glands have papillary projections, infoldings, undulations; nuclei are basal, small, hyperchromatic, with only rare nucleomegaly (Actas Urol Esp 2010;34:333)

End of Prostate > Microscopic mimics of prostatic carcinoma > Xanthoma cells

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