30b - Answer: 58-year-old male presents with malignant neoplasm of prostate
HISTORY:
This 58-year-old male presents with malignant neoplasm of prostate. History of office BPH treatment, possible microwave, and TURP.
PRIMARY FINDING:
PI-RADS 3.
FINDINGS:
Prostate gland measures 4cm in CC, 3cm in AP and 4.2cm in RL dimensions. Calculated prostate volume is 26cc. Large TURP defect is noted. Remainder of the transitional zone demonstrates generalized hypointensity with moderate to severe diffusion restriction. These areas are not mass-like in appearance and may represent scarring rather than neoplastic process (PI-RADS 3). Ill-defined T2 hypointensities in the peripheral zone without substantive diffusion restriction likely secondary to prior biopsies or prostatitis.
Anatomical prostate capsule, seminal vesicles and neurovascular bundles are clear.
Urinary bladder is partially full and unremarkable.
Prominent, likely reactive obturator lymph nodes are seen, measuring smaller than 0.5cm in short-axis. Multiple external iliac lymph nodes measuring smaller than 1cm in short-axis are also reactive in nature.
Mild capsulitis of bilateral hip joints. Mild degenerative changes of the symphysis pubis. Facet arthrosis of the lower lumbar spine. Low grade mild degenerative disc disease.
Mild diverticulosis of the sigmoid colon without evidence of acute diverticulitis.
CONCLUSION:
1. Status post TURP, generalized decreased T2 intensity and moderate to severe diffusion restriction in the remaining transitional zone (PI-RADS 3). Imaging surveillance is recommended.
2. Mild diverticulosis of the sigmoid colon without evidence of acute diverticulitis.
Case Challenge: Prostate MRI Cases
Case Challenge
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Content reviewed: October 25, 2021