Presentation
PSA 3.36. DRE benign. Are there any areas to target at biopsy?
Patient Data
Age: 70 years
Gender: Male
From the case:
Prostate cancer - unilateral PIRADS 4
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Prostate volume 82 mls. PSA density 0.04ng/ml.
9 mm PIRADS 4 lesion in the left peripheral zone at the apex.
Extensive BPH.
Normal seminal vesicles. No pelvic nodes. No bone lesions.
Sigmoid diverticulosis.
Case Discussion
A very convincing small PIRADS 4 focus (remember these are no different from PIRADS 5 in terms of imaging appearance only size).
If this lesion was more than 1.5 cm it would be a PIRADS 5.
It is surrounding by a completely normal peripheral zone.
As with the vast majority of the demographic undergoing prostate MRI, there is considerable BPH.
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