36b - Answer: 67-year-old male presents with elevated PSA of 7.03 ng/mL
HISTORY:
This 67-year-old male presents with elevated PSA of 7.03 ng/mL. Negative biopsy. BPH.
PRIMARY FINDING:
PI-RADS 4/5.
FINDINGS:
The prostate measures 6.3 x 5.4 x 4.9 for an estimated volume, using the ellipsoid formula, of 87cc and tumor density of 0.081ng/mL/cc which is in the lower end of the indeterminate risk range.
Peripheral zone: Midline prostate utricle cyst. Mildly heterogeneous signal within the peripheral zone but no diffusion restricting T2 hypointensity.
Central gland: Within the median lobe, protruding into the bladder trigone, a low T2 signal intensity diffusion restricting 1.2 x 0.8cm lesion has a positive DCE, PI-RADS 4.
No lymphadenopathy or bone lesion.
Bilateral scrotal hydroceles.
Right epididymal spermatocele. Tunica cyst right testicle.
Normal seminal vesicles. Normal rectoprostatic angles and neurovascular bundles. Normal space of Retzius.
Colonic diverticulosis.
CONCLUSION:
1. PI-RADS 4/5:
a. T2 hypointense diffusion restricting lesion within the left paramedian CZ, protruding into the bladder trigone; PI-RADS 4.
b. No peripheral zone lesion; incidental midline prostate utricle cyst.
c. No lymphadenopathy or bone lesion.
2. Scrotal hydroceles.
3. Right epididymal spermatocele.
4. Right testicular cyst, likely a tunica cyst.
5. Colonic diverticulosis.
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Content reviewed: October 25, 2021