Prostate cancer. Staging exam.Additional history per EMR: PSA 2010 2.46 ng/mL, biopsy, Gleason 3+3=6 in four cores with maximum involvement 60%. Active surveillance. March 2011, PSA 3.27, prostate biopsy Gleason 3+3=6 in one core 10%. March 2013, PSA 5.52, prostate biopsy Gleason 3+3=6 in three cores, maximum involvement 20%. October 2014, PSA 8.57 prostate biopsy Gleason 3+4=7 in two cores with maximum involvement 35%. PSA 6/19/2015 was 8.27. PELVIS:PROSTATE:Exam is limited by artifact from right hip prosthesis, markedly degrading diffusion-weighted images.Prostate Size: 5.6 x 4.6 cm.Peripheral Zone: Area of T2 hypointense signal in the left medial mid gland with suggestion of enhancement. This is incompletely evaluated without interpretable diffusion weighted images, though suspicious for patient's known prostatic adenocarcinoma.Central Gland: Marked nodularity and hypertrophy of the central zone without suspicious focal lesion.Seminal Vesicles: Seminal vesicles are unremarkable.Extracapsular Extension: There is no evidence of extracapsular extension.BLADDER: No significant abnormality noted.LYMPH NODES: Left inguinal, left pelvic sidewall, and left external iliac prominent lymph nodes are noted. Left external iliac node measures 1.9 x 1.3 cm.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Limited exam due to degradation of diffusion weighted images by artifact related to right hip prosthesis.2.Abnormality in the medial left mid gland is suspicious for patient's known prostatic adenocarcinoma. No evidence of extracapsular extension or seminal vesicle invasion.3.Prominent left inguinal, pelvic sidewall, and external iliac lymph nodes.