Basal cell hyperplasia, a common finding in benign prostatic hyperplasia, refers to proliferation of basal/ reserve cells. However, occasionally it is so florid and extensive that it can be mistaken for carcinoma. Accurate distinction separating benign and malignant lesions is critical for appropriate management. We report two elderly gentlemen who presented with signs and symptoms of prostatomegaly, histology showed florid basal cell hyperplasia with pseudo-infiltrative pattern raising a doubt of carcinoma warranting a second opinion. Review of histopathology with multiplex immunohistochemistry panel combining basal cell, metabolic, proliferation and other markers proved the benign nature of the lesion. Thereby, we conclude that although morphologic criteria guide diagnosis, immunohistochemistry confirms the benign nature resolving the dilemma even on limited material.
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