22b - Answer: 51-year-old male presents with elevated PSA level
HISTORY:
This 51-year-old male presents with elevated PSA level measuring 8.5ng/ml. No history of biopsy.
PRIMARY FINDING:
PI-RADS IV.
FINDINGS:
Prostate gland measures 4.5cm in CC, 3cm in AP and 3.8cm in RL dimensions. Calculated prostate volume is 33cc and PSA density is 0.26.
Mild hyperplasia of the transitional zone is noted. No suspicious T2 hypointensity with diffusion restriction to suggest malignant neoplastic process in the transitional zone. A 1cm x 1.2cm T2 hypointense lesion with moderate to severe diffusion restriction and early arterial enhancement is seen in the posterior peripheral zone of the left basal segment (PI-RADS 4 of 5). The lesion abuts the anatomical prostate capsule without substantive evidence of extracapsular extension or neurovascular bundle invasion. Bilateral seminal vesicles are clear.
No lymphadenopathy in the pelvis. No free or loculated fluid collections. Rectal wall is clear.
Urinary bladder is partially full and unremarkable.
Visualized aspects of the musculoskeletal structures are unremarkable.
CONCLUSION:
PI-RADS 4 of 5, dominant lesion in the posterior peripheral zone of the left basal segment, stable compared to prior study. The lesion abuts the anatomical prostate capsule without substantive evidence of extracapsular extension or neurovascular bundle invasion.
Case Challenge: Prostate MRI Cases
Case Challenge
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Content reviewed: October 25, 2021