Microscopic mimics of prostatic carcinoma
Xanthoma cells

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

Revised: 19 October 2016, last major update October 2016

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Xanthoma cells

Cite this page: Xanthoma cells. website. Accessed October 25th, 2016.
Definition / General
  • Seen in xanthoma or xanthogranulomatous prostatitis
  • Localized collection of cholesterol-laden histiocytes, usually idiopathic
  • No proven association with elevated serum lipids
  • May be interpreted as high grade prostate cancer or prostate cancer with treatment effect, or foamy gland carcinoma, particularly in needle biopsies (Hum Pathol 1994;25:386, Am J Surg Pathol 2007;31:1225)
Essential Features
  • Can be arranged in solid nodular pattern or in cords of individual cells
  • Usually very small and single focus (< 0.05 mm)
  • Bland nuclei with inconspicuous nucleoli, no mitosis, rarely focal necrosis
  • Immunohistochemistry for broad spectrum cytokeratins (negative) and CD68 (positive) should help in the differential diagnosis with carcinoma
  • Unknown; very rare
  • More commonly detected in needle biopsies
Clinical Features
  • Asymptomatic; not clinically significant
  • Histopathology and immunohistochemistry in cases difficult to differentiate from adenocarcinoma
  • Does not require treatment
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

Images hosted on other servers:

Various images


Positive Stains
Negative Stains
Differential Diagnosis
  • Foamy gland carcinoma: crowded or infiltrative glands with abundant foamy cytoplasm, frequently pink acellular secretions
  • Previously designated hypernephroid adenocarcinoma: Gleason pattern 4; 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)