Diagnostic Ultrasound - Abdomen and Pelvis

Prostatic Carcinoma
(Left) Transverse transrectal
ultrasound of the mid prostate
shows a subtle focal region of
hypoechogenicity in the right
PZ . Shadowing calcified
corpora amylacea along the
surgical capsule ſt
demarcates the boundary
between the central gland and
PZ. The right neurovascular
bundle is not involved.
(Right) Corresponding color
Doppler ultrasound shows
focal hypervascularity in the
right PZ hypoechoic lesion .
Targeted biopsy to this region
showed Gleason 3 + 3
adenocarcinoma.
Diagnoses: Urinary Tract
(Left) Axial CECT shows a
large heterogeneously
enhancing prostate mass with
regions of necrosis . The
urinary bladder is separate,
and the rectosigmoid colon st
is laterally displaced by the
mass. Pathology showed
spindle cell synovial sarcoma.
(Right) Transverse transrectal
ultrasound shows a focal
hypoechoic lesion in the left
TZ (partly outlined by dotted
yellow line). The ruler
corresponds to the biopsy
needle path. Pathology from a
targeted MR/US fusion biopsy
showed Gleason 4 + 4
adenocarcinoma.
(Left) Axial T3 MR shows an
enlarged prostate with an
irregular left PZ mass with
extraprostatic extension
and left NVB invasion .
Note: TZ hyperplasia ſt
compressing the PZ and
heterogeneous bone marrow
signal intensity, with markedly
hypointense right acetabulum
st, in keeping with
widespread osseous
metastases (later shown with
bone scan). (Right) Coronal T2
MR in same patient shows the
left PZ mass with
extraprostatic tumor
indenting the left levator ani,
stage 3 prostate cancer.
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