72 year old male patient with prostate cancer, PSA of 22. Local staging before planned prostatectomy. PELVIS:PROSTATE:Prostate Size: 5.4 x 4.3 x 3.7 cm. Peripheral Zone: The right peripheral zone is near completely replaced by heterogeneous T2 hypointensity with corresponding ADC hypointensity compatible with tumor. One region of confluent signal abnormality within the right mid-gland measures 2.5 x 0.8 cm (image 45, series 301). The right mid-gland and right base are enlarged by tumor. For example, heterogeneous T2 and ADC hypointensity within the right base measures 3.2 x 3.3 cm (image 59, series 301). There is also regions of T2 hypointensity with mild ADC hypointensity within the left peripheral zone. For example, a lesion in the left mid-gland measures 1.4 x 0.5 mm (image 47, series 301). Central Gland: There is invasion of tumor from the right peripheral zone into the right central gland with mass effect.Seminal Vesicles: There is T2 and ADC hypointensity within the bilateral seminal vesicles compatible with tumor invasion. Extracapsular Extension: There is capsule overlying the right peripheral zone is indistinct compatible with extraprostatic extension with invasion of the right neurovascular bundle.BLADDER: There are multiple bladder diverticula. LYMPH NODES: There are enlarged left internal iliac and left mesorectal lymph nodes.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Tumor enlarging the right peripheral zone and tumor in the left mid-gland with extraprostatic extension and seminal vesicle involvement as described above.2.Enlarged pelvic lymph nodes compatible with metastatic disease.3.Bladder diverticula suggesting chronic bladder outlet obstruction.