67-year-old male patient with T2a prostate cancer, Gleason 4+3, PSA 15. Evaluate for extent of disease in prostate and pelvis.Right side prostate biopsiesSpecimen: Date: 11/10/14Prostate adenocarcinoma, Gleason score 3+4=7 involving Four biopsy cores and 10% of entire tissueLeft side prostate biopsy- Focal prostatic adenocarcinoma, Gleason score 3+3=6 involving <5 % of tissue PELVIS:PROSTATE:Prostate Size: 5.4 x 3.4 x 3.9 cm (ML x AP X CC).Peripheral Zone: There is a 1.5 x 0.7 cm (series 604 image 264) focus of decreased T2 and ADC signal in the mid right peripheral zone extending towards the apex.There is a 1.5 x 0.6 cm (series 604 image 324) focus of decreased T2 and ADC signal in the mid left peripheral zone.Central Gland: No suspicious lesions.Seminal Vesicles: No evidence of seminal vesicle involvement.Extracapsular Extension: Lesion in the right peripheral zone abuts the capsule without evidence of extracapsular extension.BLADDER: No significant abnormality noted.LYMPH NODES: Scattered small subcentimeter lymph nodes bilaterally in the pelvis.BONES, SOFT TISSUES: Patchy enhancement is noted in the bones the pelvis.OTHER: No significant abnormality noted.
1.Likely neoplastic foci in the mid right peripheral zone extending towards the apex as well as in the left peripheral zone without evidence of extracapsular extension or significant pelvic lymphadenopath as described above.2.Mottled, patchy enhancement of the bones in the pelvis. When correlated with outside hospital CT and recent bone scan, favor Paget's disease over metastatic disease.