This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Urology, Subject name: Surgery
Which of the following is NOT associated with elevation of prostatic specific antigen? 
Select and explain. 
A. Acute prostatitis, B. BPH, C. Prostatic intraepithelial neoplasm, D. Prostatic needle biopsy
C: Prostatic intraepithelial neoplasm
Answer: C: Prostatic intraepithelial neoplasm 
Explanation: Prostatic Intraepithelial Neoplasia ( PIN) is a precancerous condition; not detected by rectal examination, TRUS , or MRI; does not cause rise in PSA level . It is usually identified after TURP for BPH with final histology or by prostatic biopsy.Reference: page1048 SRB&;s manual of surgery 5th edition