Male 65 years old with high volume Gleason 4+3 prostate cancer in left lobe and Gleason 3+4 prostate cancer in right lobe. PELVIS:PROSTATE:Prostate Size: 5.7 x 3.9 x 4.9 cm.Peripheral Zone: Linear foci of T1 hyperintensity are compatible with mild hemorrhage from prior biopsy. There is a lesion in the centered in left mid gland (appears to extend from base towards apex) that is hypointense on T2 and ADC demonstrates early contrast enhancement suspicious for adenocarcinoma. It measures 20 x 11 mm in the midgland (series 1001, image 16) and 11 x 8 mm in the apex (series 1001, image 12). There is indistinctness of the capsule at the level of the lesion, suspicious for extracapsular extension, and abutment of the neurovascular bundle. A small focus in the right midgland/apex (series 1001, image 13) has similar imaging characteristics and is suspicious for an additional site of adenocarcinoma (series 1001, image 13).Central Gland: Multiple BPH nodules.Seminal Vesicles: No significant abnormality noted.Extracapsular Extension: Indistinctness of the capsule in the left mid gland suspicious for extracapsular extension with abutment of the neurovascular bundle.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Bilateral foci suspicious for prostate adenocarcinoma with findings concerning for extracapsular extension and involvement of the neurovascular bundle on the left.