Elevated PSA. Questionable lesion on prior prostate biopsy. The patient reports an outside hospital biopsy demonstrating adenocarcinoma which was subsequently reviewed by pathology and deemed to be high-grade prostatic intraepithelial neoplasia. PELVIS:PROSTATE:Prostate Size: 5.0 x 5.8 x 6.5 cmPeripheral Zone: In the left paramedial mid gland/apex there is a 1.3 x 0.9 cm focus of T2-weighted hyperintensity restricted diffusion and arterial enhancement suspicious for prostatic adenocarcinoma. The right peripheral zone demonstrates linear T2 weighted hypointensity without a discrete lesion.Central Gland: Changes of benign prostatic hyperplasia. No suspicious lesion.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: The left paramedial mid gland lesion abuts the capsule which is mildly thinned but no definite extracapsular extension.BLADDER: Small urachal cyst or diverticulum at the dome of the bladder.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.3 cm focus in the left paramedial mid gland/apex is suspicious for prostatic adenocarcinoma. This lesion is amenable to MRI/ultrasound fusion biopsy. No seminal vesicle invasion, extracapsular extension or pelvic lymphadenopathy.