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CC BY-NC-ND 4.0 · J Lab Physicians 2014; 6(01): 043-045
DOI: 10.4103/0974-2727.129091
Case Report

A Unique Case of Diffuse Histiocytic Proliferations Mimicking Metastatic Clear Cell Carcinoma in the Hydrocele Sac

Authors

  • Shirish S Chandanwale

    Department of Pathology, Padmashree Dr. DY Patil Medical College, Pimpri, Pune, Maharashtra, India

  • Shruti S Vimal

    Department of Pathology, Padmashree Dr. DY Patil Medical College, Pimpri, Pune, Maharashtra, India

  • Mohit Rajpal

    Department of Pathology, Padmashree Dr. DY Patil Medical College, Pimpri, Pune, Maharashtra, India

  • Neha Mishra

    Department of Pathology, Padmashree Dr. DY Patil Medical College, Pimpri, Pune, Maharashtra, India

Source of Support: Nil.
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ABSTRACT

Reactive histiocytic proliferations are extremely rare in paratesticular structures. Nodular histiocytic proliferations have been described in mesothelial-lined locations and only at few nonmesothelial sites. Diffuse histiocytic proliferations are described only in the pelvic peritoneum. We report the first case of diffuse histiocytic proliferation in the hydrocele sac of a 45-year-old man. Predominant histiocytes showed clear cytoplasm and signet ring-like change. Mucicarmin stain did not demonstrate mucin in the cytoplasm. Immunohistochemistry (IHC) staining showed nonspecific staining of these cells with carcinoembryonic antigen and negative staining with epithelial membrane antigen, pan-Cytokeratin, calretinin, cytokeratin 7, 20 and prostate-specific antigen. Strong diffuse cytoplasmic positivity for CD68 defined the mononuclear phagocyte nature of these cells. Diffuse histiocytic proliferations can occur in the hydrocele sac. Histochemical and IHC stainings are critical for accurate diagnosis and to avoid unnecessary surgery.

Key words:

Clear cells - diffuse - histiocytes - Immunohistochemistry - signet ring cells


Publication History

Article published online:
19 April 2020

© 2014.

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  • REFERENCES

  • 1 Algaba F, Mikuz G, Boccon-Gibod L, Trias I, Arce Y, Montironi R, et al. Pseudoneoplastic lesions of the testis and paratesticular structures. Virchows Arch 2007;451:987-97.
  • 2 Ordóñez HG, Ro JY, Ayala AG. Lesions described as nodular mesothelial hyperplasia are primarily composed of histiocytes. Am J Surg Pathol 1998;22:285-92.
  • 3 Rosai J, Dehner LP. Nodular mesothelial hyperplasia in hernia sacs: A benign reactive condition simulating a neoplastic process. Cancer 1975;35:165-75.
  • 4 Rao S, Khurana N, Mohta A. Nodular histiocytic proliferation in hernial sac: A potential diagnostic pitfall. Indian J Pathol Microbiol 2012;55:126.
  • 5 Chikkamuniyappa S, Herrick J, Jagirdar JS. Nodular histiocytic/mesothelial hyperplasia: A potential pitfall. Ann Diagn Pathol 2004;8:115-20.
  • 6 Wang CW, Colby TV. Histiocytic lesions and proliferations in the lung. Semin Diagn Pathol2007;24:162-82.
  • 7 Chan JK, Loo KT, Yau BK, Lam SY. Nodular histiocytic/mesothelial hyperplasia: A lesion potentially mistaken for a neoplasm in transbronchial biopsy. Am J Surg Pathol1997;21:658-63.
  • 8 Ruffolo R, Suster S. Diffuse histiocytic proliferation mimicking mesothelial hyperplasia in endocervicosis of the female pelvic peritoneum. Int J Surg Pathol1993;1:101-5.
  • 9 Fukunaga M, Iwaki S. Nodular histiocytic hyperplasia of the endometrium. Arch Pathol Lab Med2004;128:1032-4.
  • 10 Kim KR, Lee YH, Ro JY. Nodular histiocytic hyperplasia of the endometrium. Int J Gynecol Pathol2002;21:141-6.
  • 11 Iezzoni JC, Mills SE. Nonneoplastic endometrial signet-ring cells. Vacuolated decidual cells and stromal histiocytes mimicking adenocarcinoma. Am J Clin Pathol 2001;115:249-55.