Microscopic mimics of prostatic carcinoma
Xanthoma cells

Authors: Komal Arora, M.D. (see Authors page)

Revised: 22 August 2016, last major update June 2012

Copyright: (c) 2003-2016,, Inc.

PubMed search: prostatic xanthoma cells
Definition / General
  • 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

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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)