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  9b (Prostate) - Answer: 77-year-old male presents with elevated PSA level

HISTORY: 

This 77-year-old male presents with elevated PSA level measuring 7.33ng/mL.


PRIMARY FINDING: 

PI-RADS IV. 


Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.


FINDINGS:

The prostate gland measures 3.8cm in CC, 4cm in RL and 2.8cm in AP dimensions. Calculated prostate volume is 28cc and PSA density is 0.26. Mild transitional zone hyperplasia is present. A 1.5cm x 1.3cm T2 hypointense mass with severe diffusion restriction and early arterial enhancement is present at the anterior peripheral zone of the apex, involving both sides. The lesion abuts and causes bulging of the anatomical prostate capsule without substantive evidence of extracapsular extension. Involvement of the transitional zone is also noted. Bilateral neurovascular bundles and seminal vesicles are clear. 

Rectal wall and rectal prostatic angles are normal. 

Urinary bladder is not completely full. No focal wall thickening or diverticular formation identified. 

No lymphadenopathy in the pelvis. 

No abnormal osseous enhancement identified. Mild capsulitis of bilateral hip joints. Intraosseous ganglion formation is noted at the posterior inferior nonweightbearing surface of the right femoral head. 

 

CONCLUSION

PI-RADS 4/5, the dominant lesion is in the anterior peripheral zone of the apex, which also involves the transitional zone. No extracapsular extension.


Discussion

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430577 1572452 9703966 9b (Prostate) - Answer: 77-year-old male presents with elevated PSA level /courses/430577/lectures/9703966 true native_comments
430577 1572452 9703966 9b (Prostate) - Answer: 77-year-old male presents with elevated PSA level /courses/430577/lectures/9703966 true text

HISTORY: 

This 77-year-old male presents with elevated PSA level measuring 7.33ng/mL.


PRIMARY FINDING: 

PI-RADS IV. 


Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.


FINDINGS:

The prostate gland measures 3.8cm in CC, 4cm in RL and 2.8cm in AP dimensions. Calculated prostate volume is 28cc and PSA density is 0.26. Mild transitional zone hyperplasia is present. A 1.5cm x 1.3cm T2 hypointense mass with severe diffusion restriction and early arterial enhancement is present at the anterior peripheral zone of the apex, involving both sides. The lesion abuts and causes bulging of the anatomical prostate capsule without substantive evidence of extracapsular extension. Involvement of the transitional zone is also noted. Bilateral neurovascular bundles and seminal vesicles are clear. 

Rectal wall and rectal prostatic angles are normal. 

Urinary bladder is not completely full. No focal wall thickening or diverticular formation identified. 

No lymphadenopathy in the pelvis. 

No abnormal osseous enhancement identified. Mild capsulitis of bilateral hip joints. Intraosseous ganglion formation is noted at the posterior inferior nonweightbearing surface of the right femoral head. 

 

CONCLUSION

PI-RADS 4/5, the dominant lesion is in the anterior peripheral zone of the apex, which also involves the transitional zone. No extracapsular extension.