26b - Answer: 65-year-old male presents with elevated PSA
HISTORY:
This 65-year-old male presents with elevated PSA. Negative biopsy for cancer.
PRIMARY FINDING:
PI-RADS 2/5.
FINDINGS:
The prostate measures 5.8 x 6.2 x 8.5cm for an estimated volume, using the ellipsoid formula, of 160cc.
Peripheral Zone: Slightly heterogeneous T2 signal but no restricted diffusion.
Central Gland: CZ/TZ hypertrophy protruding into the bladder trigone. Bladder wall thickening compatible with outlet obstruction.
Heterogeneous T2 signal throughout the CZ/TZ with prominent cystic change.
Heterogeneous diffusion signal throughout the CZ/TZ, unchanged.
Small scrotal hydroceles.
No lymphadenopathy or bone lesion.
Heterogeneous postcontrast enhancement throughout the prostate.
Normal space of Retzius, rectoprostatic angles, neurovascular bundles.
Normal seminal vesicles.
CONCLUSION:
1. PI-RADS 2/5
a. No change in mild scarring of the prostate peripheral zone.
b. No change in massive BPH and outlet obstruction resulting in bladder wall thickening.
c. No change in heterogeneous diffusion signal throughout the prostate, without new or increasing finding to raise suspicion for hypervascular or invasive neoplasm.
Case Challenge: Prostate MRI Cases
Case Challenge
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Content reviewed: October 25, 2021