Microscopic mimics of prostatic carcinoma
Basal cell hyperplasia (BCH)

Author: Andres Matoso, M.D. (see Authors page)

Revised: 31 May 2016, last major update April 2016

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Prostate Basal cell hyperplasia[title]

Related topics: Basal cell hyperplasia with prominent nucleoli and Florid basal cell hyperplasia

Cite this page: Basal cell hyperplasia. website. Accessed October 23rd, 2016.
Definition / General
  • Basal cell hyperplasia is the expansion of the basal cells within the prostatic acini
  • May mimic prostate adenocarcinoma when prominent nucleoli are present
Essential Features
  • May be arranged in small crowded glands, often back to back forming pseudocribriform glands
  • Solid nests can be seen frequently
  • Scant cytoplasm, prominent nucleoli
  • Can show coarse calcifications or eosinophilic (hyaline) cytoplasmic globules
  • Also called fetalization of the prostate, embryonal hyperplasia
  • Adults
  • Although more common in TURP specimens, can also be seen in needle biopsies and radical prostatectomies
Prognostic Factors
  • Not associated with adverse prognosis or higher risk of cancer
Micro Description
  • At low magnification, basal cell hyperplasia is characterized by a basophilic appearance
  • Cells have scant cytoplasm, blue nuclei and prominent nucleoli
  • Can form solid nests, back-to-back glands, pseudocribriform glands
  • Coarse calcifications and intracytoplasmic eosinophilic inclusions
Micro Images
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Florid basal
cell hyperplasia

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Basal cell carcinoma

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Various images

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Peripheral zone images


Positive Stains
Negative Stains
Differential Diagnosis
  • High grade prostatic intraepithelial neoplasia: basal cells are not easily identifiable. HGPIN nuclei are columnar while basal cell hyperplasia nuclei are rounded. PIN glands are in general larger than glands in basal cell hyperplasia
  • Prostate adenocarcinoma: carcinoma is negative for HMWCK and p63 and positive for AMACR, while basal cell hyperplasia is positive for HMWCK and p63 and negative for AMACR
  • Basal cell carcinoma: Carcinoma is characterized by different sizes nests, adenoid cystic pattern, center of nest lined by eosinophilic cells, stron bcl-2 immunostaining and >20% Ki67 positive cells
Additional References
  • Montironi R, Lopez-Beltran A, Cheng L, Galosi AB, Montorsi F, Scarpelli M. Seminal vesicle intraepithelial neoplasia versus basal cell hyperplasia in a seminal vesicle (Eur Urol 2014 Oct;66:623)
  • Bohn OL, Rios-Luna NP, Navarro L, Duran-Pena A, Sanchez-Sosa S. Basal cell carcinoma of the prostate gland: a case report and brief review of the basal cell proliferations of the prostate gland (Ann Diagn Pathol 2010 Oct;14:365)