History of prostate cancer. PELVIS:PROSTATE:Prostate Size: 2.0 x 4.2 x 4.5 cmPeripheral Zone: 1.0 x 0.5 cm right medial apex lesion demonstrating decreased T2 weighted signal intensity (series 1/16), restricted diffusion (series 1003/304) and arterial enhancement with washout (series 2101/6 79).Additional focus in the left medial apex measuring 6 x 5 mm with similar imaging characteristics (series 801/60).5 x 5 mm focus in the anterior right lateral mid gland demonstrating decreased T2 weighted signal intensity and restricted diffusion (series 801/19).Central Gland: Changes of benign prostatic hyperplasia.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: The right mid gland lesion abuts and bulges the adjacent fibromuscular capsule (series 801/19) without frank extraprostatic extension.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: Bowel containing left inguinal hernia is incompletely characterized. Heterogeneous marrow signal intensity with a focus of enhancement in the left ischial tuberosity.OTHER: No significant abnormality noted.
1. Suspected multifocal prostatic adenocarcinoma with a dominant lesion in the right medial apex. No evidence of seminal vesicle invasion. Possible extraprostatic extension of a right anterior lateral mid-gland lesion.2. Heterogeneous bone marrow signal intensity, with an enhancing focus in the left ischial tuberosity without definite corresponding increase in radiotracer uptake on the outside hospital nuclear medicine bone scan. This may be degenerative in etiology.3. Large left inguinal hernia containing bowel, incompletely imaged but without evidence of complication. 