32b - Answer: 79-year-old male presents with elevated PSA level measuring 12 ng/mL
HISTORY:
This 79-year-old male presents with elevated PSA level measuring 12 ng/mL. History of negative biopsy.
PRIMARY FINDING:
PI-RADS 2 of 5.
FINDINGS:
Prostate gland measures 6cm in CC, 4.5cm in AP and 6cm in RL dimensions. Calculated prostate volume is 85cc and PSA density is 0.14. Transitional zone hyperplasia and evidence of TURP are noted. No suspicious T2 hypointense area of a substantive diffusion restriction to suggest malignant neoplastic process in the transitional zone. Compression of the peripheral zone with generalized T2 hypointensity without mass-like appearance suggests fibrotic change. No diffusion restrictive lesion and without early arterial enhancement to suggest malignant neoplastic process in the peripheral zone. Prostate capsule, bilateral neurovascular bundles and seminal vesicles are clear. Low T2 signal is seen in the seminal vesicles which may represent proteinaceous or hemorrhagic content.
No enlarged lymph nodes are identified in the pelvis or inguinal regions.
Rectum wall and rectoprostatic angles are clear.
Urinary bladder is not full; however, it demonstrates increased trabecular pattern.
Status post bilateral total hip prosthesis which decreases the image quality on diffusion-weighted images.
Vasculature is patent. No hernia identified.
Musculature and tendons are unremarkable. Evidence of left inguinal hernia repair.
CONCLUSION:
1. PI-RADS 2 of 5, benign hyperplasia of the transitional zone.
2. Indentation of the enlarged transitional zone to urinary bladder floor with increased trabecular appearance of the bladder wall.
3. No focal metastatic process.
Case Challenge: Prostate MRI Cases
Case Challenge
Browse other topics in...
Content reviewed: October 25, 2021