central zone gland

Definition: The central zone (CZ) is located at the base of the prostate adjacent to the seminal vesicles. Its histology can be potential mimicker of high-grade prostatic intraepithelial neoplasia (PIN).

See also

 prostatic central zone

Images

 glands of central zone at the base of the prostate

• http://www.webpathology.com/image.asp?n=15&Case=19
• http://www.webpathology.com/image.asp?n=16&Case=19

CZ histology is distinctive, as seen in radical prostatectomy specimens. Less frequently it is found on needle biopsy, where the presence of Roman arch and/or cribriform formation mimics PIN.

Recognition of the distinctive features of CZ histology (i.e., tall columnar cells with eosinophilic cytoplasm, prominent basal cell layer, and lack of cytologic atypia) can help avoid a misdiagnosis of PIN or "atypia" on needle biopsy.

Differential diagnosis

 HGPIN

• CZGs lack atypia

 prostate cancer

• The diagnosis of prostate cancer is made based on the architecture of the glandular proliferation and nuclear atypia, but some normal structures (seminal vesicle, Cowper’s glands, prostatic central zone) or nonneoplastic proliferative lesions can mimic carcinoma.
• Of the 3 patterns of prostate cancer—solid, cribriform, and microglandular, the microglandular pattern is the one that imitates carcinoma most frequently on needle biopsy.
• The demonstration of basal cells can be the best method to identify these prostate cancer mimickers.

References

 Mimickers of prostate cancer in needle biopsies. Algaba F, Trias I. Anal Quant Cytopathol Histpathol. 2015 Feb;37(1):57-64. PMID: 26072635

 Central zone histology of the prostate: a mimicker of high-grade prostatic intraepithelial neoplasia. Srodon M, Epstein JI. Hum Pathol. 2002 May;33(5):518-23. PMID: 12094377