18b - Answer: 56-year-old male presents with abnormal PSA
HISTORY:
This 56-year-old male presents with abnormal PSA of 18. Family history of prostate cancer in three uncles and two cousins. No know prostate cancer.
POTENTIAL CLASSIFICATION:
PI-RADS IV - V.
FINDINGS:
The prostate measures 5.9 x 4.9 x 6.5cm for an estimated volume, using the ellipsoid formula, of 98cc and tumor density, given the PSA of 18, of 0.183ng/ml/cc which is in the high-risk range.
Peripheral zone: Heterogeneous signal throughout the peripheral zone which is compressed.
Central gland: Left apex TZA, diffusion restriction, T2 hypointensity, and vascularity. The T2 signal is equivocal.
BPH with bladder wall thickening compatible with outlet obstruction.
Normal seminal vesicles.
Normal rectoprostatic angles and neurovascular bundle.
No lymphadenopathy or bone lesion.
Normal pelvic and extrapelvic musculature.
CONCLUSION:
1. PI-RADS 4-5:
a. Ill-defined T2 hypointense area of decreased diffusion involving the anterior left apex TZA measuring 1.0 x 1.3cm.
b. CZ/TZ hypertrophy and bladder wall thickening compatible with outlet obstruction.
2. No lymphadenopathy or bone lesion.
3. The prostate volume estimate is 80cc.
Case Challenge: Prostate MRI Cases
Case Challenge
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Content reviewed: October 25, 2021