Hyperplasia of the median lobe of the prostate produces a polypoid mass that protrudes in the bladder lumen.
Basal cell hyperplasia is usually seen in the transition zone. Occasionally, it may be encountered in needle biopsies (which sample peripheral zone).
The nuclei are ovoid or round with finely reticular chromatin and rare punctate nucleoli. The cytoplasm is pale eosinophilic or clear
Lobular clusters of glands with cribriform architecture
The glandular clusters have punched out lumens. The cytoplasm is clear or pale eosinophilic. The nuclei are uniform and lack nucleoli. Basal cells can be clearly seen.
Large atypical cells with hyperchromatic nuclei containing intranuclear vacuoles are interspersed between benign glands. Prostatic stromal hyperplasia with atypia
| Atypical Adenomatous Hyperplasia in Needle Biopsy Atypical adenomatous hyperplasia (adenosis) - when seen in a needle biopsy - is one of the most challenging benign mimics of cancer. A partially sampled focus of cancer may be mistaken for AAH |
AAH encountered in a transurethral resection specimen.
The immunostain for high molecular weight cytokeratin 34bE12 demonstrates fragmented basal cell layer in the previous focus of AAH.
Clusters of atrophic prostatic acini with proliferative changes. At low magnification, it may be mistaken for adenocarcinoma; however, they lack cytologic features of cancer such as prominent nucleoli.
This case is not difficult to distinguish from prostatic adenocarcinoma. In challenging cases, the immunostain for high molecular weight cytokeratin is invaluable
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