59b - Answer: 55-year-old male presents with elevated prostate specific antigen
HISTORY:
This 55-year-old male presents with elevated prostate specific antigen.
PRIMARY FINDING:
PI-RADS 5/5.
FINDINGS:
Prostate measures 5.1cm transverse, 4.96cm cranial to caudal and 4.1cm anterior to posterior for a volume of 67.64cc and tumor density of 0.118ng/mL/cc.
Central and transitional zone prostate hypertrophy with bladder wall thickening compatible with chronic outlet obstruction.
Normal seminal vesicles, rectoprostatic angles, space of Retzius.
In the right prostate peripheral zone PZPL, midway between the apex and base, an oval 2.1 x 1.4 x 0.7cm diffusion restricting lesion has a long capsular contact of at least 2cm but does not bulge the capsule or invade the rectoprostatic angle. There is also hypervascular enhancement at the periphery of this lesion.
No adenopathy.
Colonic diverticulosis.
Mild degenerative joint disease. No bone lesion.
Small scrotal hydrocele suspected.
CONCLUSION:
1. PI-RADS 5/5:
a. Right peripheral zone PZPL T2 hypointense diffusion restricting vascular lesion, midway between the apex and base, concerning for neoplasm.
b. Central and transitional zone hypertrophy with chronic bladder outlet obstruction.
c. No sign of bone lesion or adenopathy.
2. Colonic diverticulosis.
Case Challenge: Prostate MRI Cases
Case Challenge
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Content reviewed: October 25, 2021