21b - Answer: 65-year-old male presents with elevated PSA level
HISTORY:
This 65-year-old male presents with elevated PSA level measuring 6.2ng/mL. Positive family history of prostate cancer. History of negative prostate biopsy.
PRIMARY FINDING:
PI-RADS III.
FINDINGS:
The prostate gland measures 4.8cm in CC, 4.4cm in AP and 4.5cm in RL dimensions. Calculated prostate volume is 62cc and PSA density is 0.1.
Transitional zone hyperplasia is noted. Two focal T2 hypointense regions smaller than 0.5cm in diameter with moderate to severe diffusion restriction at the posterior aspect of the basal segment just deep to the central zone (PiRADS 3 of 5). Otherwise, no suspicious area to suggest malignant neoplastic process in the peripheral or transitional zone. Anatomical prostate capsule appears intact. Bilateral neurovascular bundles and reactive prostatic angles are clear. Bilateral seminal vesicles demonstrate severe atrophy.
No enlarged lymph nodes in the pelvis or inguinal regions.
No free or loculated fluid collections.
No suspicious osseous enhancement identified.
Small hydrocele is noted at the film edge.
CONCLUSION:
1. PiRADS 3 of 5. The lesions are located at the posterior transitional zone of the right and left basal segments.
2. Severe atrophy of bilateral seminal vesicles.
Case Challenge: Prostate MRI Cases
Case Challenge
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Content reviewed: October 25, 2021