Comments:In this benign gland, the luminal contour shows tufts and papillary infoldings. The tall secretory epithelial cells have pale clear cytoplasm and uniform round or oval nuclei. Prominent nucleoli are not seen. Many basal cells can be identified.   return to Normal Prostate and Seminal Vesicles

Comments:This benign gland contains corpora amylacea. Even at low magnification, basal cells can be clearly seen. Compare this with next slide which highlights the basal cell layer with the immunostain for high molecular weight cytokeratin 34bE12.   return to Normal Prostate and Seminal Vesicles

Male Reproductive System prostate, secretory epithelium

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The normal histologic appearance of prostate glands and surrounding fibromuscular stroma is shown here at high magnification. A small pink concretion (typical of the corpora amylacea seen in benign prostatic glands) appears in the gland just to the left of center. Note the well-differentiated glands with tall columnar epithelial lining cells. These cells do not have prominent nucleoli.

A normal prostate gland is about 3 to 4 cm in diameter. This prostate is enlarged due to prostatic hyperplasia, which appears nodular. Thus, this condition is termed either BPH (benign prostatic hyperplasia) or nodular prostatic hyperplasia.

Here is another example of benign prostatic hyperplasia. Nodules appear mainly in the lateral lobes. Such an enlarged prostate can obstruct urinary outflow from the bladder and lead to an obstructive uropathy.

Microscopically, benign prostatic hyperplasia can involve both glands and stroma, though the former is usually more prominent. Here, a large hyperplastic nodule of glands is seen.

Prostate - histology topTransition zone5% of prostatic volume; 2 pear shaped lobes surrounding proximal urethraSite of nodular prostatic hyperplasia, may expand to bulk of glandSite of 10% of prostate cancers (large duct carcinomas)Contains moderately compact fascicles of smooth muscle Central zone25% of prostatic volume; surrounds transition zone to angle of urethra to bladder baseSite of 5% of prostate cancersUnlike peripheral and transition zones, ducts are large and irregular; glands are complex with tall columnar, pseudostratified, papillary infoldings; striking basal cell layer with eosinophilic cytoplasmStroma is densest in central zone, least dense in peripheral zone, in between for transition zoneReference: Hum Path 2002;33:518 Peripheral zone70% of prostatic volume, from apex posterior to base, surrounds transition and central zonesSite of 80% of prostate cancersHas loose fibromuscular stroma with widely spaced smooth muscle bundles, moderate gland complexity Prostatic non-glandular tissue“Capsule”: fibromuscular layer most prominent along base and posterior portion of lateral borders; an inseparable component of prostatic stroma, not a distinct capsule, AJSP 1989;13:21Along lateral borders, fibrous septa traverse periprostatic fat and merges with fibromuscular stromaAnteriorly, prostatic stroma merges with fibromuscular tissue of urogenital diaphragmStroma contains abundant smooth muscle, which duplicates function of myoepithelial cells in breast; i.e. squeezes out secretions Prostatic glandular tissueProstate glands found normally within skeletal muscle at apex, anteriorly, and in distal posterolateral glandSecrete normal mucins, produce pigment (lipofuscin), are androgen sensitive (castration causes atrophy); differentiation and growth is androgen dependentLarge prostatic ducts have single layer of urothelial-like epithelium without umbrella cells, which is PSA/PAP positive; may undergo squamous metaplasia with estrogen therapyBenign tissue may contain hyaline globules (degenerative, aka thanatosomes, AJSP 2003;27:700), may be adjacent to skeletal muscle or nervesMicro images: image1, image2, image3, concretions #1, #2, stroma #1, #2, spermatozoa Type of cellssecretory cells, basal cells, scattered neuroendocrine cells, urothelium, ejaculatory duct/seminal vesicle type cells Secretory cellsLocated along glandular lumenPositive stains: prostatic acid phosphatase (PAP), prostate-specific antigen (PSA), vimentin, keratin (some), Leu7/CD57, EMA (80%), CEA (25%)Negative stains: CK903 (34 beta E12, high molecular weight keratin) Basal cellsSeparate secretory cells from basement membrane; consist of low cuboidal epithelium and columnar mucus secreting cells; may have prominent nuclear groove, prominent nucleoliMay be reserve cells (stem cells), can undergo myoepithelial metaplasia but are NOT myoepithelial cellsTheir presence differentiates benign conditions (basal cells are present) from well differentiated adenocarcinoma (not present)Micro images: 34betaE12Positive stains: CK903 (34 beta E12 / high molecular weight keratin), p63, androgen receptorsNegative stains: PSA, PAP, S100, actin Neuroendocrine cellsIrregularly distributedMicro images: image1Positive stains: chromogranin A, B, secretogranin II, peptide hormones, PSANegatives stains: androgen receptors UrotheliumIn proximal 2 mm of prostatic ducts Ejaculatory ducts and seminal vesiclesLined by double cell layer of pseudostratified epithelium, contain lipofuscin (golden-brown pigment), have large, hyperchromatic nuclei (also called "monster" nuclei), may have intranuclear inclusions MucinsNormal mucins are neutral; most adenocarcinomas secrete acidic and neutral mucins Glandular secretionsCan identify with glutaraldehyde based fixatives, fill the normal secretory cell cytoplasm, distinct bright red on H&E staining because of high polyamine content; also present in penile urethra, Hum Path 2002;33:905