Anatomical Pathology Interesting Case Conference

Microscopic Description:

Histology reveals group of glands with mucin filled distended cells. The cell are non-neoplastic without any atypia.

IHC revealed Triple Stain (P504S, HMW Keratins, P63) staining of basal cells of prostate gland.

Histology revealed another morphology which showed glandular crowding and round pleomorphic nuclei with loss of basal cells and AMACR+.

Discussion:

It is common finding. It may mimic or co-exist with cancer therefore it is important to rule out cancer. It is commonly seen after radiation therapy.

It often affects elderly males, mostly in the periurethral region. Often asymptomatic but can have symptoms of urinary frequency, urgency, dysuria. Serum PSA is frequently normal.

Microscopically, tall prostatic acinar cells filled with abundant mucin in the cytoplasm. The gland/ group of glands have flat basal pyknotic nuclei. It resembles cowper’s gland.

Immunohistochemical analysis shows positivity for PAS, Mucicarmine, Alician blue and negative for cytokeratins, PSA and PSAP.

Diagnosis is through TURP. No treatment is required. Frequent follow up for monitoring of neoplastic change.

References:

Shiraishi T, Kusano I, Watanabe M, Yatani R, Liu PI. Mucous gland metaplasia of the prostate. Am J Surg Pathol. 1993 Jun;17(6):618-22.

 

Osunkoya AO. Mucinous and secondary tumors of the prostate. Mod Pathol. 2018 Jan;31(S1):S80-S95.

 

Bohman KD, Osunkoya AO. Mucin-producing tumors and tumor-like lesions involving the prostate: a comprehensive review. Adv Anat Pathol. 2012 Nov;19(6):374-87.

Egvevad L, Delahunt B, furusato b, Tsuzuki T, Yaxley J, Samaratunga H. Benign mimics of prostate cancer. Pathology 2021 Jan; Vol 53:1,26-35

Case Images