74b - Answer: 59-year-old male presents with elevated PSA level 5.85ng/mL
HISTORY:
This 59-year-old male presents with elevated PSA level 5.85ng/mL one year prior. Negative biopsy nine years prior. No surgery. No cancer.
PRIMARY FINDING:
PI-RADS 2 of 5.
FINDINGS:
The prostate gland measures 3.6cm in CC, 3.7cm in AP, and 5.2cm in transverse dimensions. Calculated prostate volume is 56.4cc and PSA density is 0.10ng/mL/cc. Transitional zone hyperplasia is present. No suspicious T2 hypointense area with diffusion restriction to suggest malignant neoplastic process in the peripheral or transitional zones. Anatomical prostate capsule, bilateral neurovascular bundles and seminal vesicles are clear.
Urinary bladder is partially full and unremarkable. Indentation of the enlarged transitional zone to urinary bladder floor is noted.
Rectal wall is intact. Rectoprostatic fat planes are preserved.
Substantive generalized decreased T2 signal in the peripheral zone without diffusion restriction is most consistent with fibrotic changes and scarring.
No enlarged lymph nodes in the pelvis or inguinal regions.
Iliac arteries and veins are widely patent at the visualized aspects.
Mild capsulitis of bilateral hip joints noted. Otherwise, the musculoskeletal structures are within normal limits.
CONCLUSION:
1. PI-RADS 2 of 5, benign hyperplasia of the transitional zone.
2. Scarring in the peripheral zone of the prostate gland.
3. Mild capsulitis of bilateral hip joints.
Case Challenge: Prostate MRI Cases
Case Challenge
Browse other topics in...
Content reviewed: October 25, 2021