Elevated PSA. Evaluate for prostate cancer. PELVIS:PROSTATE:Prostate Size: 5.0 x 5.9 x 5.8 cmPeripheral Zone: No intrinsic T1-weighted signal hyperintensity. The peripheral zone is diffusely thinned with scattered linear regions of T2 weighted hyperintensity.In the left mid gland medial region there is a vague region of T2 weighted hypointensity measuring 1.1 x 0.5 cm (series 901/21).In the paramedial apex there is a 1.7 x 1.0 cm region of T2 weighted hypointensity (series 901/14). This lesion may be associated with early washout relative to the remainder of the peripheral zone on dynamic phase imaging (series 1 501/1 230).The diffusion weighted images are limited by artifact.Central Gland: Moderately enlarged due to hyperplasia. No discrete suspicious lesion.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: No evidence of extracapsular extension.BLADDER: No significant abnormality noted.LYMPH NODES: Several small external iliac lymph nodes. The largest is a right external iliac lymph node measuring 1.1 cm in short axis (series 160 0 1/108). Shotty subcentimeter retroperitoneal lymph nodes extending to the aortic bifurcation are are also noted but are nonspecific.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Left paramedial mid gland and paramedial apex lesions are suspicious for prostatic adenocarcinoma and are amenable to MRI/ultrasound fusion biopsy.2. Mildly prominent pelvic lymph nodes.