Prostate gland & seminal vesicles
Benign mimickers of carcinoma
Xanthoma cells
Author: Andres Matoso, M.D.
Topic Completed: 1 October 2016
Minor changes: 21 July 2021
Copyright: 2002-2021, PathologyOutlines.com, Inc.
PubMed Search: Xanthoma cells
Table of Contents
Definition / general | Essential features | Epidemiology | Sites | Clinical features | Diagnosis | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Matoso A. Xanthoma cells. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/prostatexanthoma.html. Accessed December 3rd, 2021.
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
Epidemiology
- Unknown; very rare
Sites
- More commonly detected in needle biopsies
Clinical features
- Asymptomatic; not clinically significant
Diagnosis
- Histopathology and immunohistochemistry in cases difficult to differentiate from adenocarcinoma
Treatment
- Does not require treatment
Microscopic (histologic) 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
Microscopic (histologic) images
Contributed by Kenneth A. Iczkowski, M.D.
Xanthomatous histiocyte proliferation
CD68 positive stain - confirmatory
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)
