History of prostate cancer status post robotic-assisted laparoscopic prostatectomy on 5/27/2016. His final pathology revealed Gleason 4+5 disease with positive margins at the L peripheral and L apex, 2/19 node involvement on the right with largest lymph node tumor being 15 mm with extranodal invasion, tumor volume 65%, pT3bN1MxR1. Recent PSA is 0.29, post-operatively was 0.11. Preoperatively PSA=11.85 ng/ml PELVIS:PROSTATE:Prostate Size: Patient is status post prostatectomy.Peripheral Zone: Patient is status post prostatectomy.Central Gland: Patient is status post prostatectomy.Seminal Vesicles: Patient is status post prostatectomy.Extracapsular Extension: Patient is status post prostatectomy.BLADDER: No significant abnormality noted.LYMPH NODES: Left external iliac T2 hyperintense lesion measuring 2.4 x 1.1 cm (series 1901 image 95). This lesion has no internal enhancement and favor lymphocele. Previously seen right external iliac lymph node is not definitely seen on current study and may have been surgically removed. Tiny nonspecific periprostatic lymph node.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Left external iliac T2 hyperintense lesion without internal enhancement, favor lymphocele. 2.Tiny nonspecific periprostatic lymph node, but no specific evidence of disease recurrence.PI-RADS™ v2 Assessment Categories:PIRADS 1 – Very low (clinically significant cancer is highly unlikely to be present) PIRADS 2 – Low (clinically significant cancer is unlikely to be present)PIRADS 3 – Intermediate (the presence of clinically significant cancer is equivocal)PIRADS 4 – High (clinically significant cancer is likely to be present) PIRADS 5 – Very high (clinically significant cancer is highly likely to be present)https://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/PIRADS/PIRADS%20V2.pdf