56b - Answer: 50-year-old male presents with elevated PSA of 7.05
HISTORY:
This 50-year-old male presents with elevated PSA of 7.05. Negative biopsy four years prior.
PRIMARY FINDING:
PI-RADS 2/5.
FINDINGS:
The prostate measures 4.6 x 4.6 x 3.9cm for an estimated volume, using the bullet formula, of 53.6cc and bullet tumor density of 0.131ng/mL/cc which is in the lower end of the high risk range.
Peripheral Zone: Heterogeneously decreased peripheral zone signal without diffusion restricting hypointensity or suspicious focal hypervascularity.
Central Gland: CZ/TZ hypertrophy protruding to the bladder trigone. Bladder wall thickening compatible with outlet obstruction. No suspicious diffusion restricting T2 hypointensity within the CZ or TZ.
Small scrotal hydroceles.
Normal seminal vesicles.
Normal rectoprostatic angles and neurovascular bundles.
Normal space of Retzius.
The visualized bowel is normal.
Fluid filled right inguinal hernia without complication.
CONCLUSION:
1. PI-RADS 2/5:
a. No suspicious T2 hypointensity, diffusion restriction or hypervascularity.
b. BPH resulting in bladder outlet obstruction and bladder wall thickening.
c. No lymphadenopathy or bone lesion.
Case Challenge: Prostate MRI Cases
Case Challenge
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Content reviewed: October 25, 2021