28b - Answer: 75-year-old male presents with elevated PSA level
HISTORY:
This 75-year-old male presents with elevated PSA level, and history of transurethral resection of the prostate (TURP).
PRIMARY FINDING:
PI-RADS 5 of 5.
FINDINGS:
Prostate gland measures 4.3cm in CC, 3.3cm in AP and 4.6cm in RL dimensions. Calculated prostate volume is 42cc. TURP defect is noted. A T2 hypointense region measuring 1.7cm x 2cm is noted at the anterior transitional zone of the right mid and apical segment with moderate to severe diffusion restriction (PI-RADS 5/5). No suspicious T2 hypointense region with substantive diffusion restriction and/or early arterial enhancement and washout to suggest malignant neoplastic process in the peripheral zone. Anterior transitional zone lesion demonstrates abutment to the anterior fibromuscular stroma without evidence of extracapsular extension. Bilateral neurovascular bundles and atrophic seminal vesicles are clear. Rectoprostatic angles are preserved.
No enlarged lymph nodes in the pelvis or inguinal regions.
No free or loculated fluid collections.
Urinary bladder is not full. No substantive wall thickening or diverticula formation.
Musculoskeletal structures are grossly normal.
Small fat containing inguinal hernias are noted.
CONCLUSION:
PI-RADS 5 of 5, dominant lesion is at the anterior transitional zone of the right mid and apical segment.
Case Challenge: Prostate MRI Cases
Case Challenge
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Content reviewed: October 25, 2021