73-year-old man with additional history as per chart: PSA of 4.9 on 5/2016 and status post biopsy revealing Gleason 7 disease. PELVIS:PROSTATE:Prostate Size: 42 x 27 mmPeripheral Zone: There is a 12 x 12 x 12 mm focus of T2 hypoattenuation, diffusion restriction, and enhancement seen in the mid left peripheral zone (series 801, image 14). Additionally, there is an approximately 9 x 5 mm area of low T2 signal and diffusion restriction in the right prostatic base (series 801, image 17) and a 4 x 4 millimeter area of low T2 signal and diffusion restriction in the mid right peripheral zone (series 801, image 13).Central Gland: The central gland is unremarkable.Seminal Vesicles: The seminal vesicles appear normal.Extracapsular Extension: There is loss of normal capsular signal along the left posterolateral aspect (series 01, image 14), however the adjacent neurovascular bundle appears uninvolved.BLADDER: The bladder is normal.LYMPH NODES: No significant lymphadenopathy noted.BONES, SOFT TISSUES: Small focus of juxta-articular high T1 signal on postcontrast images in the right sacral ala (series 2301, image 163) is noted, however this area is not covered on the precontrast T1 images. Additionally, there is an area of T1 and T2 hypointensity in the right pubic symphysis (series 501, image 84) which slightly enhances.OTHER: No significant abnormality noted.
1.Lesion in the mid left peripheral zone with extracapsular extension highly suspicious for adenocarcinoma.2.Additional suspicious areas of signal abnormality in the right peripheral zone.3.Partially imaged lesion in the right sacral ala and right pubic symphysis which are nonspecific but may be further evaluated with nuclear medicine bone scan to exclude metastatic foci.