66b - Answer: 55-year-old male presents with prostate neoplasm
HISTORY:
This 55-year-old male presents with prostate neoplasm. PSA 5.02 ng/mL.
PRIMARY FINDING:
PI-RADS 4.
FINDINGS:
The prostate gland measures 4.7cm tall, 4.6cm wide and 3.6cm anterior to posterior.
Midway between the apex and base of the prostate at the paramedian right side of the peripheral zone, a 1.36 x 1.11 x 1.36cm T2 hypointense lesion is visible on image 18-19 of series 501 and 20 of series 401. The associated signal on the ADC velocity map is decreased. There is also increased enhancement in this region, image 18 of series 901. No other areas of abnormal T2 or diffusion signal abnormality.
The seminal vesicles are normal.
Moderate transitional zone hypertrophy.
The space of Retzius is normal.
The bladder is diffusely thickened without focal bladder lesion, finding compatible with chronic outlet obstruction.
The rectoprostatic angles are normal. No sign of extracapsular invasion.
No pelvic adenopathy. Intrapelvic sacral perineural cyst on the right as an incidental finding. Mild SI joint arthropathy. Mild symphysis pubis arthrosis. No destructive bone lesion. No acute fracture. Normal musculature. The visualized bowel is normal.
CONCLUSION:
1. PI-RADS 4 lesion in the right paramedian peripheral zone of the prostate in the posterior gland midway between the apex and base. No sign of adenopathy or extraprostatic extension. Capsule abutted but not violated.
2. Transitional known prostatic hypertrophy with bladder wall thickening suggestive of chronic outlet obstruction.
3. Right sacral perineural cyst as an incidental finding.
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Content reviewed: October 25, 2021