Elevated PSA. History of prostate cancer. 3/15/2011 biopsy showed 3+3 mm 20% right medial base, 3+ 3 2-mm 10% right lateral base and 3+ 3 1-mm 10% right lateral mid. PELVIS:PROSTATE:Prostate Size: 3.6 x 6.3 x 5.3 cm.Peripheral Zone: No significant intrinsic T1 weighted signal hyperintensity. In the right paramedial base there is a 1.2 x 8 mm focus of T2 weighted hypointensity (series 801/17) associated with restricted diffusion (series 1004/324) and asymmetric early enhancement (series 1 701/1 935) which may correspond to the patient's known site of prostatic adenocarcinoma. There is some adjacent low T2-weighted signal intensity which crosses the midline which likely predominantly represents the central zone, unchanged in appearance from the prior.1.5 x 0.9 cm nodule adjacent to the left base anterior surgical capsule (peripheral zone/central gland junction) demonstrates very low T2-weighted signal intensity (series 801/18), restricted diffusion (series 1004/344) and early arterial enhancement (series 1701/2095). This is increased in size from the prior study.Additional punctate T2 weighted hyperintense foci in the peripheral zone measuring less than 3 to 4 mm.Central Gland: Changes of benign prostatic hyperplasia.Seminal Vesicles: The right base lesion signal abnormality may extend into the right seminal vesicle (series 601/15).Extracapsular Extension: No evidence of extra capsular extension.BLADDER: Partially distended urinary bladder.LYMPH NODES: No enlarged pelvic lymphadenopathy.BONES, SOFT TISSUES: Probable mild focal synovitis adjacent to the right superolateral posterior hip joint. No arterially enhancing bone lesion.OTHER: No significant abnormality noted.
1.1.2 cm right paramedial base lesion is suspicious for prostatic adenocarcinoma with findings suspicious for extension into the right seminal vesicle.2.Left anterior base 1.5 cm lesion is suspicious for prostatic adenocarcinoma, increased from the prior study.