63-year-old male with prostate cancer. Staging exam.Additional history per EMR: PSA 2.5 in 2010 , 4.13 in 2012, 6 in 2013 and 5.5 in 10/2014.PSA on March 9, 2015 was 8.4. US guided biopsy on 5/6/2015, prostatic adenocarcinoma Gleason 6 in 1 of 7 cores on the left (3 were taken from the apex) and high-grade PIN presented in cores taken from the right and left base and the right lateral apex. Maximal involvement was 70% of the positive core from the left apex. PELVIS:PROSTATE:Prostate Size: 6.4 x 3.6 cm.Peripheral Zone: Scattered areas of T1 hyperintense signal likely reflect hemorrhage or scarring from recent biopsy. Lesions in the left base and right apex demonstrate hypointense signal on T2 and ADC sequences with possible enhancement of the left base nodule. The lesion in the left base also abuts the capsule, and extracapsular invasion therefore cannot be excluded.Central Gland: Multiple well-defined nodules without suspicious features.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: No evidence of extracapsular extension.BLADDER: No significant abnormality noted.LYMPH NODES: No significant lymphadenopathy is identified.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Lesions in the left base and right apex of the peripheral zone are suspicious for prostatic carcinoma. Lesion in the left base abuts the capsule and extracapsular invasion therefore cannot be excluded.