61b - Answer: 66-year-old male presents with elevated PSA
HISTORY:
This 66-year-old male presents with elevated PSA. History of biopsy five years prior.
PRIMARY FINDING:
PI-RADS 4.
FINDINGS:
Prostate is enlarged measuring 6.7cm transverse x 5.4cm AP x 4.3cm craniocaudad with prostate volume if 81 grams. Transitional zone hypertrophy present. A 5mm, T2-dark nodule present right anteromedial apical peripheral zone with restricted diffusion. No abnormal contrast enhancement, however, nodule is suspicious and consistent with PI-RADS 4. No other suspicious thyroid nodules evident.
Neurovascular bundles, seminal vesicles and anatomic prostate capsule intact. Surgical capsule disrupted bilaterally due to hypertrophic nodules in the transitional zone. Retropubic and retroprostatic spaces intact. No bulky adenopathy in the pelvis.
Urinary bladder mildly trabeculated.
CONCLUSION:
1. 5mm T2-dark nodule right anteromedial apical peripheral zone with restricted diffusion. PI-RADS 4.
2. Enlarged prostate with transitional zone hypertrophy.
Case Challenge: Prostate MRI Cases
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Content reviewed: October 25, 2021