35b - Answer: 59-year-old male presents with elevated PSA level measuring 15.5 ng/mL
HISTORY:
This 59-year-old male presents with elevated PSA level measuring 15.5 ng/mL. History of positive prostate biopsy identifying low grade carcinoma.
PRIMARY FINDING:
PI-RADS 4/5.
FINDINGS:
The prostate gland measures 4.6cm in CC, 4.4cm in RL and 3.8cm in AP dimensions. Calculated prostate volume is 50cc and PSA density is 0.31. Transitional zone hyperplasia is present. An ill-defined lens-shaped 2.5cm x 2.5cm x 0.8cm hypointense lesion with severe diffusion restriction is demonstrated at the anterior transitional zone of bilateral mid and apical segments. The lesion demonstrates extension posteriorly at the left apical segment. The lesion abuts the anterior fibromuscular stroma without evidence of extracapsular extension. Bilateral neurovascular bundles, rectoprostatic angles and seminal vesicles are clear. No abnormal T2 hypointensity with substantive diffusion restriction to suggest malignant neoplastic process in the peripheral zone.
No lymphadenopathy identified in the pelvis or inguinal regions. Urinary bladder is unremarkable.
No abnormal osseous enhancement. Visualized aspects of the musculoskeletal structures are grossly normal.
CONCLUSION:
1. PI-RADS 4/5, the dominant lesion at the anterior transitional zone of bilateral mid and apical segments. Abutment or local invasion of the anterior fibromuscular stroma without evidence of extracapsular extension.
2. Mild capsulitis of bilateral hip joints.
Case Challenge: Prostate MRI Cases
Case Challenge
Browse other topics in...
Content reviewed: October 25, 2021