case_images: PMC11116681_01
case_images: Suspicious primary focus at 4 points in the left lobe of the prostate gland (yellow arrow) (A, B). Right femoral neck, left pubic bone and sciatic metastases (blue arrow) (A, C, D).
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case_images: T2WI showed: prostate left lobe at 4 o'clock, see a diameter of about 0.6cm small round slightly shorter T2 signal ( Figures 1A-D ).
case_images: Bone destruction of the thoracic vertebrae and soft tissue mass formation at the root of the ribs are seen (blue arrow) (A, B). The patient lay prone on the CT examination bed; one strip of puncture tissue was taken and sent for analysis (C, D).
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case_images: T2WI, 5 points for DWI, 5 points for DCE, and 5 points for the overall score, which was a PCa nodule (T2N2M1b). Thoracic CT: multiple bone destruction and some soft tissue mass formation in the thoracic spine area, and metastatic tumor lesions were considered (metastatic foci depicted in  Figures 2A, B ). The patient was lying prone on the CT examination bed, and the CT was localized to the metastasis at the root of the right 7th rib ( Figures 2C, D ), and one strip of puncture tissue was obtained and sent for examination.
case_images: Benign prostatic hyperplasia was observed in the left and right lobes (A). Punctured tissue smear shows daisy-like heterogeneous cell clusters (B). Prostate follicular carcinoma, CK (+), P504S (+), PSA (+), PSAP (+), and Vimentin (-) are shown by immunohistochemistry (C-H).
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case_images: Postoperative pathological findings showed (left and right lobes) benign prostatic hyperplasia (BPH); immunohistochemical staining showed epithelial cells: CK-H, p63 (indicating the presence of myoepithelium), and P504S (luminal margin +) ( Figure 3A ). Postoperative immunohistochemical results: prostate follicular carcinoma, Gleason score: 5 + 4, CK (+), P504S (+), PSA (+), PSAP (+), and wave protein (-), suggestive of metastatic PCa ( Figures 3B-H ).