Anatomy and Normal Histology of the Prostate Pertinent to Biopsy Interpretation

  • Rajal B. Shah
  • Ming Zhou


In an adult man without significant prostatic hyperplasia, the prostate gland is shaped like an inverted cone and weighs 30–40 g. It is located within the pelvis, with its base proximally at the bladder neck and its apex distally at the urogenital diaphragm. It lies anterior to the rectum, with the urethra running through its center and serving as an important reference landmark. Therefore, the prostate is amenable to transrectal needle biopsy and transurethral resection. Anatomically, it comprises three zones with different volume, histology, and disease preference.


Prostate Prostate gland histology Prostate gland anatomy Prostate epithelial cell types Secretory cells Basal cells Prostate zones Peripheral zone Central zone Transition zone Anterior fibromuscular layer Seminal vesicle/ejaculatory ducts Intraprostatic structures Verumontanum Corpora amylacea Lipofuscin Basal cell hyperplasia Urothelial metaplasia Mucinous metaplasia Cowper’s glands Atrophy High-grade prostatic intraepithelial neoplasia Perineural abutment Prostate capsule Prostate-periprostatic boundary Extraprostatic extension Immunophenotype PSA PSAP NKX3.1 High molecular weight cytokeratin p63 p40 Neuroendocrine differentiation Paneth cells 


  1. 1.
    McNeal J. In: Mills S, editor. Prostate. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 997–1097.Google Scholar
  2. 2.
    Bostwick D. Normal anatomy and histology. In: Bostwick D, Dundore P, editors. Biopsy pathology of the prostate. London: Chapman & Hall; 1997. p. 1–26.Google Scholar
  3. 3.
    van Leenders GJ, Gage WR, Hicks JL, van Balken B, Aalders TW, Schalken JA, et al. Intermediate cells in human prostate epithelium are enriched in proliferative inflammatory atrophy. Am J Pathol. 2003;162:1529–37.CrossRefGoogle Scholar
  4. 4.
    Marker PC, Donjacour AA, Dahiya R, Cunha GR. Hormonal, cellular, and molecular control of prostatic development. Dev Biol. 2003;253:165–74.CrossRefGoogle Scholar
  5. 5.
    Bieberich CJ, Fujita K, He WW, Jay G. Prostate-specific and androgen-dependent expression of a novel homeobox gene. J Biol Chem. 1996;271:31779–82.CrossRefGoogle Scholar
  6. 6.
    Signoretti S, Loda M. Defining cell lineages in the prostate epithelium. Cell Cycle. 2006;5:138–41.CrossRefGoogle Scholar
  7. 7.
    Zhou M, Shah R, Shen R, Rubin MA. Basal cell cocktail (34betaE12 + p63) improves the detection of prostate basal cells. Am J Surg Pathol. 2003;27:365–71.CrossRefGoogle Scholar
  8. 8.
    Signoretti S, Waltregny D, Dilks J, Isaac B, Lin D, Garraway L, et al. p63 is a prostate basal cell marker and is required for prostate development. Am J Pathol. 2000;157:1769–75.CrossRefGoogle Scholar
  9. 9.
    Epstein JI, Amin MB, Beltran H, Lotan TL, Mosquera JM, Reuter VE, et al. Proposed morphologic classification of prostate cancer with neuroendocrine differentiation. Am J Surg Pathol. 2014;38(6):756–67.CrossRefGoogle Scholar
  10. 10.
    Christian JD, Lamm TC, Morrow JF, Bostwick DG. Corpora amylacea in adenocarcinoma of the prostate: incidence and histology within needle core biopsies. Mod Pathol. 2005;18:36–9.CrossRefGoogle Scholar
  11. 11.
    Brennick JB, O’Connell JX, Dickersin GR, Pilch BZ, Young RH. Lipofuscin pigmentation (so-called “melanosis”) of the prostate. Am J Surg Pathol. 1994;18:446–54.CrossRefGoogle Scholar
  12. 12.
    Viglione MP, Potter S, Partin AW, Lesniak MS, Epstein JI. Should the diagnosis of benign prostatic hyperplasia be made on prostate needle biopsy? Hum Pathol. 2002;33:796–800.CrossRefGoogle Scholar
  13. 13.
    Srodon M, Epstein JI. Central zone histology of the prostate: a mimicker of high-grade prostatic intraepithelial neoplasia. Hum Pathol. 2002;33:518–23.CrossRefGoogle Scholar
  14. 14.
    Babinski MA, Chagas MA, Costa WS, Sampaio FJ. Prostatic epithelial and luminal area in the transition zone acini: morphometric analysis in normal and hyperplastic human prostate. BJU Int. 2003;92:592–6.CrossRefGoogle Scholar
  15. 15.
    Amin MB, Bostwick DG. Pigment in prostatic epithelium and adenocarcinoma: a potential source of diagnostic confusion with seminal vesicular epithelium. Mod Pathol. 1996;9:791–5.PubMedGoogle Scholar
  16. 16.
    Gagucas RJ, Brown RW, Wheeler TM. Verumontanum mucosal gland hyperplasia. Am J Surg Pathol. 1995;19:30–6.CrossRefGoogle Scholar
  17. 17.
    Cina SJ, Silberman MA, Kahane H, Epstein JI. Diagnosis of Cowper’s glands on prostate needle biopsy. Am J Surg Pathol. 1997;21:550–5.CrossRefGoogle Scholar
  18. 18.
    Kawabata K. Paraganglion of the prostate in a needle biopsy: a potential diagnostic pitfall. Arch Pathol Lab Med. 1997;121:515–6.PubMedGoogle Scholar
  19. 19.
    Gardner WA Jr, Culberson DE. Atrophy and proliferation in the young adult prostate. J Urol. 1987;137:53–6.CrossRefGoogle Scholar
  20. 20.
    Postma R, Schroder FH, van der Kwast TH. Atrophy in prostate needle biopsy cores and its relationship to prostate cancer incidence in screened men. Urology. 2005;65:745–9.CrossRefGoogle Scholar
  21. 21.
    Hosler GA, Epstein JI. Basal cell hyperplasia: an unusual diagnostic dilemma on prostate needle biopsies. Hum Pathol. 2005;36(5):480–5.CrossRefGoogle Scholar
  22. 22.
    Ali TZ, Epstein JI. Perineural involvement by benign prostatic glands on needle biopsy. Am J Surg Pathol. 2005;29:1159–63.CrossRefGoogle Scholar
  23. 23.
    Fine SW, Al-Ahmadie HA, Gopalan A, Tickoo SK, Scardino PT, Reuter VE. Anatomy of the anterior prostate and extraprostatic space: a contemporary surgical pathology analysis. Adv Anat Pathol. 2007;14:401–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Rajal B. Shah
    • 1
  • Ming Zhou
    • 2
  1. 1.Robert J Tomsich Pathology and Laboratory Medicine InstituteCleveland ClinicClevelandUSA
  2. 2.Tufts Medical CenterBostonUSA

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