62 year old male with elevated PSA. Evaluate for prostate carcinoma. PELVIS:PROSTATE:Prostate Size: 4.8 x 2.5 x 3.6 cm (TR x AP x CC)Peripheral Zone: There is extensive decreased T2 signal abnormality with associated restricted diffusion and enhancement in the left posterior base of the peripheral zone of the prostate gland which is suspicious for prostate carcinoma. This extends into the left base and mid body anteriorly as well. There is an additional focus of enhancing signal abnormality in the left posterior apex of the peripheral zone of the prostate gland which is also suspicious for prostate carcinoma.Note is made of multiple foci of signal abnormality with restricted diffusion and enhancement in the right mid body and base of the peripheral zone of the prostate which are also suspicious for prostate carcinoma. Seminal Vesicles: There appears to be extension of signal abnormality in the left posterior base to the level of the left seminal vesicle which raises the question of seminal vesicle involvement by tumor. Extracapsular Extension: There is a capsular bulge along the aforementioned areas of signal abnormality which is suspicious for extensive extracapsular extension with involvement of the left seminal vesicle and probable extension to involve the neurovascular bundle. BLADDER: There is concentric thickening of the bladder suggestive of chronic outlet obstruction.LYMPH NODES: No evidence of lymphadenopathy. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Multiple foci of signal abnormality in the left base, body, and apex of the peripheral zone of the prostate gland, suspicious for prostate carcinoma. There is apparent extracapsular extension and probable involvement of the left seminal vesicle. No evidence of lymphadenopathy.