33b - Answer: 78-year-old male presents with elevated PSA level measuring 5.39 ng/mL
HISTORY:
This 78-year-old male presents with elevated PSA level measuring 5.39 ng/mL. History of positive biopsy.
PRIMARY FINDING:
PI-RADS 5 of 5.
FINDINGS:
Prostate gland measures 4.5cm in CC, 2.8cm in AP and 4.6cm in RL dimensions. Calculated prostate volume is 38cc and PSA density is 0.14.
Transitional zone hyperplasia is present. Ill-defined T2 hypointensity measuring approximately 3cm in long-axis is present in the basal segment through apical segment peripheral zone anterior aspect with severe diffusion restriction and early arterial enhancement (PI-RADS 5 of 5). Small area of extracapsular extension is suspected at the right mid segment.
Neurovascular bundles and seminal vesicles are clear.
No enlarged lymph nodes in the pelvis. Urinary bladder is distended and unremarkable.
Visualized musculoskeletal structures are within normal limits.
CONCLUSION:
PI-RADS 5 of 5, lesion in the basal segment through apical segment peripheral zone. Small area of extracapsular extension is suspected at the right mid segment.
Case Challenge: Prostate MRI Cases
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Content reviewed: October 25, 2021