Reason: Evaluate for potential tumor History: Elevated PSA and negative biopsy x3. PELVIS:PROSTATE: Prostate Size: 3.9 x 5.3 x 4.4 centimeters.Peripheral Zone: Involvement of the right apical and mid gland peripheral zone by large transitional zone tumor as described below. Central Gland: Large dominant tumor involving the right greater than left anterior apical and mid transitional zone with extension into the right peripheral zone. There is T2 hypointense signal, restricted diffusion, and early enhancement. This tumor measures 2.9 x 3.8 x 2.2 cm (AP x TR x CC; series 1201 x image 14, series 1101 image 13). There is bulging of the prostate contour anteriorly, suspicious for extracapsular extension. There is invasion of the anterior fibromuscular stroma. Seminal Vesicles: No significant abnormality noted.Extracapsular Extension: Extracapsular extension of tumor suspected anteriorly. BLADDER: No significant abnormality noted.LYMPH NODES: Prominent right pelvic sidewall lymph node with rounded configuration measures 1.6 x 1 cm (series 3201 image 62).BONES, SOFT TISSUES: Left fat-containing inguinal hernia. Mild deformity and abnormal signal involving the right inferior pubic ramus, may be a chronic healed fracture. OTHER: No significant abnormality noted.
1.Large anterior tumor involving the transitional zone of the right greater than left apex and mid prostate with extension into the anterior fibromuscular stroma and right apical and mid peripheral zone. Extracapsular extension suspected.2.Mildly enlarged right pelvic sidewall lymph node.3.Mild deformity and abnormal signal involving the right inferior pubic ramus, may be a chronic healed fracture. However, if there is clinical concern for metastatic disease, this would be better assessed with dedicated nuclear medicine bone scintigraphy.