12b - Answer: 62-year-old male presents with elevated PSA level
HISTORY:
This 62-year-old male presents with elevated PSA level measuring 8.3ng/mL; no biopsy or surgery. No family history of cancer.
PRIMARY FINDING:
PI-RADS II.
FINDINGS:
The prostate gland measures 6cm in CC, 5cm in AP, and 6cm in RL dimensions. Calculated prostate volume is 94cc and PSA density is 0.09. Transitional zone hyperplasia is present. Stromal hyperplasia areas demonstrate mild to moderate diffusion restriction. No suspicious T2 hypointensity with substantive diffusion restriction to suggest malignant neoplastic process in the transitional zone. Peripheral zone demonstrates linear T2 hypointense scarring regions. Anatomical prostate capsule, bilateral neurovascular bundles, rectoprostatic angles and seminal vesicles are clear.
No lymphadenopathy in the pelvis or inguinal regions. Subcentimeter in diameter right external iliac chain lymph node is noted.
Mild diverticular disease of the sigmoid colon without evidence of acute diverticulitis. Rectal wall is unremarkable.
Visualized musculoskeletal structures are within normal limits.
Urinary bladder is partially full and demonstrates mild wall thickening. No pseudo diverticula formation.
CONCLUSION:
1. PI-RADS 2; benign hyperplasia of the transitional zone.
2. Mild diverticular disease of the sigmoid colon without evidence of acute diverticulitis.
3. DWI images did not cover the whole prostate. Patient will be call back for complete DWI imaging.
ADDENDUM:
Additional diffusion-weighted images through the prostate are obtained. No substantive diffusion-restricted, T2-hypointense region in the transitional or peripheral zone of the prostate gland to suggest malignant neoplastic process.
Case Challenge: Prostate MRI Cases
Case Challenge
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Content reviewed: October 25, 2021