65b - Answer: 61-year-old male presents with PSA level of 3.1ng/mL
HISTORY:
This 61-year-old male presents with PSA level of 3.1ng/mL.
PRIMARY FINDING:
PI-RADS 4.
FINDINGS:
Prostate findings: The prostate is enlarged measuring 6cm in CC, 4.7cm in AP and 5.5cm in RL dimensions. Transitional zone hyperplasia is present. Two areas of ill-defined T2 hypointensities are identified in the prostate base, right TZp segment and left mid-apex TZa segment measuring 1.5cm x 2cm and 1cm x 0.9cm, respectively. These areas demonstrate mild to moderate diffusion restriction. No substantive difference in enhancement compared with the rest of the transitional zone. No evidence of suspicious T2 hypointensity or restricted diffusion in the peripheral zone. The central zone is compressed. Enlarged median lobe of the prostate gland demonstrates urinary bladder floor indentation. Diffuse wall thickening of the urinary bladder is noted.
Bilateral seminal vesicles, prostate anatomical capsule and bilateral neurovascular bundles are unremarkable. A midline cyst measuring 2cm x 1.5cm is noted in the seminal vesicle likely acquired.
Extraprostatic findings: No enlarged lymph nodes identified in the pelvis or inguinal regions. Colonic diverticulosis.
Musculature and osseous structures are unremarkable.
CONCLUSION:
1. PI-RADS 4, ill-defined T2 hypointense regions with mild to moderate diffusion restriction in the right basal TZp and left mid gland-apex TZa lesions as described in the body of the report.
2. Seminal vesicle cyst, most likely acquired.
3. Colonic diverticulosis.
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Content reviewed: October 25, 2021