Elevated PSA. His PSA over the last several years has been in the range of 3-4, but in August rose to 5.3 ng/mL. He was referred to a urologist (Dr Lyon in Naperville) who repeated a free/total PSA which showed a PSA of 5.6 ng/mL with free/total ratio of 11%. No Biopsy. PELVIS:PROSTATE:Prostate Size: 3.1 x 4.2 x 4.7 cmPeripheral Zone: In the left lateral mid gland there is a 1.4 x 1.0 x 1.1 cm lesion demonstrating low T2 weighted signal intensity (series 901/15), restricted diffusion (series 704/284) and avid early enhancement with washout (series 1501/1531).Central Gland: 8 mm right mid gland transitional zone T2 weighted hypointense lesion (series 901/16) with restricted diffusion (series 7 04/304) is very well-defined and likely represents a BPH nodule. Additional changes of benign prostatic hyperplasia.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: The left lateral mid gland lesion has a broad base abutting and bulging the lateral fibromuscular "capsule".BLADDER: No significant abnormality noted.LYMPH NODES: Small non-specific 5 mm lymph node at the aortic bifurcation. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.4 cm lesion in the left lateral mid gland is very suspicious for prostatic adenocarcinoma. It has a broad base and bulges the fibromuscular "capsule" suspicious for probable extraprostatic extension. 