Elevated PSA. No pathology available.October of 2015 was found to have a PSA of 36 ng/mL. In November it was repeated and found to be 41 ng/mL. In September of 2015, he underwent a transrectal ultrasound-guided biopsy which showed no evidence of cancer. Hesubsequently underwent an MRI on November 25, 2015, which suggested an abnormality measuring approximately 2 cm at the right base and mid portion of his prostate within the transition zone and extending anteriorly into the periprostatic space. An MR-guided biopsy at that point suggested 16 mm ofGleason 8 cancer at the right mid, 5 mm of Gleason 8 cancer at the right apex, 5 mm of Gleason 8 cancer at the left mid. PELVIS:PROSTATE:Prostate Size: 3.9 x 5.3 x 4.6 cmPeripheral Zone: The peripheral zone is relatively T2 weighted hyperintense with several band like linear regions of hypointensity. There is also nearly diffuse T1-weighted hyperintensity of the peripheral zone, findings compatible with blood product, and limiting evaluation. Bandlike focal thickening in the right lateral apex measuring 1.0 x 0.6 cm (series 301/53) demonstrating low T2 weighted signal intensity, likely related to blood product. Ill-defined region of low ADC and T2-weighted signal in the left mid-gland (series 403/184 and series 601, image 15) may represent a site of disease.No additional discrete abnormality. Central Gland: Centered in the right mid gland is 2.1 x 2.0 x 2.1 cm T2-weighted mildly hypointense poorly defined lesion (series 801 /14) with associated restricted diffusion (series 403/264). The lesion demonstrates avid relatively early enhancement (series 1 401/2 337).Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: The mass centered in the right mid gland transitional zone appears to extend anteriorly where it obscures the right anterolateral prostatic margin suspicious for extraprostatic extension.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Dominant 2.1 cm lesion in the mid-portion of the right mid-gland with suspected right anterolateral extraprostatic extension. 