Sebo T J, Bostwick D G, Farrow G M, Eble J N
Department of Pathology, Mayo Clinic, Rochester, MN 55905.
Hum Pathol. 1994 Apr;25(4):386-9. doi: 10.1016/0046-8177(94)90147-3.
Xanthoma is a localized collection of cholesterol-laden histiocytes that is usually idiopathic, but may be seen in patients with hyperlipidemia. We report seven cases of xanthoma involving the prostate, including one arising in a patient with mild hyperlipidemia. Prostatic xanthoma appeared as a solitary microscopic lesion in the peripheral zone (six cases) or transition zone (one case). One needle biopsy specimen with xanthoma was initially interpreted as well-differentiated adenocarcinoma with a clear cell (hypernephroid) pattern, but immunohistochemical studies revealed the histiocytic nature of the proliferation. Five cases (three needle biopsy specimens and two retropubic prostatectomy specimens) contained a solitary xanthoma adjacent to foci of adenocarcinoma. Another xanthoma was present in a transurethral resection specimen with nodular hyperplasia. Although unusual, xanthoma should be considered in the differential diagnosis of clear cell adenocarcinoma and other clear cell proliferations of the prostate, particularly in limited tissue samples, such as from needle biopsies and transurethral resections.
黄色瘤是富含胆固醇的组织细胞的局部聚集，通常为特发性，但也可见于高脂血症患者。我们报告了7例累及前列腺的黄色瘤病例，其中1例发生于轻度高脂血症患者。前列腺黄色瘤表现为外周区（6例）或移行区（1例）的孤立性微观病变。1例含黄色瘤的针吸活检标本最初被误诊为具有透明细胞（肾上腺样瘤）模式的高分化腺癌，但免疫组化研究显示该增殖具有组织细胞性质。5例（3例针吸活检标本和2例耻骨后前列腺切除标本）在腺癌灶附近有孤立性黄色瘤。另一例黄色瘤存在于伴有结节性增生的经尿道切除标本中。尽管不常见，但在前列腺透明细胞腺癌和其他透明细胞增殖性病变的鉴别诊断中，尤其是在有限的组织样本（如针吸活检和经尿道切除术样本）中，应考虑黄色瘤。
