1b (Prostate) - Answer: 64-year-old male presents elevated PSA

HISTORY: 

This 64-year-old male presents elevated PSA.


(QUIZ ANSWER) 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:

Prostate measures 4.8cm in transverse dimension, 4.2cm in AP dimension and 4.5cm in craniocaudal dimension with calculated bullet volume of 59mL. 

An 8mm hypointensity at the posterolateral left apical peripheral zone with restricted diffusion and arterial enhancement. Wedge-shaped mild hyperintensity in the remaining peripheral zones. No restricted diffusion. Cordlike stromal hyperplasia with glandular hyperplasia in the transitional zones. No erased charcoal sign. Capsules intact. Neurovascular bundle unremarkable. Seminal vesicles are unremarkable. 

No lymphadenopathy in the visualized pelvis. 

Severe colonic diverticulosis. 

Bilateral inguinal hernia with fat. 

 

CONCLUSION: 

1. 8mm hypointensity with restricted diffusion and enhancement at the posterolateral apical left peripheral zone. PI-RADS 4. No evidence of regional metastases. 

2. Colonic diverticulosis.