Elevated PSA. Per medical record, referred for ongoing management of elevated PSA. His PSA was elevated to 10.84 ng/mL in January 2009, so a TRUS guided biopsy was performed in March 2009 and was reportedly negative for prostate cancer. He was subsequently followed with serial PSA exams and in July of 2013 his PSA had risen to 16.8 ng/mL. He was recommended to undergo repeat biopsy but was actually lost to follow up. Recently underwent biopsy which revealed benign tissue. PELVIS:PROSTATE:Prostate Size: 6.2 cm LR x 4.3 cm AP x 6.5 cm CC. Peripheral Zone: The study is limited due to T1 hyperintense signal throughout the midportion of the left half of the peripheral zone from the base to apex and much of the right peripheral zone. Although, there is diffuse hypointensity of this region on the ADC, given the diffuse bright T1 signal, suggesting hemorrhage we do not favor tumor. No suspicious early arterial enhancing lesions on the dynamic contrast-enhanced images.Central Gland: Heterogenous and enlarged with nodules, compatible with severe BPH.There is an ill-defined focus in the anterior apex measuring 1.3 x 0.7 cm (series 1504/184) which demonstrates restricted diffusion and T2-weighted hypointensity. This may be a portion of the transition zone, however tumor is a consideration.Seminal Vesicles: No evidence of seminal vesicle invasionExtracapsular Extension: No evidence of extracapsular extension. BLADDER: No significant abnormality noted.LYMPH NODES: Non-specific right external iliac/femoral lymph node measuring 7 mm in short-axis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Ill-defined 1.3 cm focus in the anterior apex may be part of the transition zone, however tumor is a consideration.2.Otherwise, limited study due to extensive T1 hyperintense signal of the peripheral zone suggesting hemorrhage. No suspicious focus in the peripheral zone is evident.