case_images: PMC8054861_01
case_images: PMC8054861_02
case_images: (a) A focus of Gleason GG2 prostatic adenocarcinoma on a targeted core in the 2nd biopsy; (b) T2-weighted image shows lenticular homogeneous moderately hypointense lesion (arrow) measuring 1.5 cm located in right anterior transitional zone in midgland, representative of Prostate Imaging Reporting and Data System category 5; (c) apparent diffusion coefficient map shows marked focal hypointensity (arrow); (d) a single focus of Gleason GG4 prostatic adenocarcinoma on a systematic core in the 3rd biopsy; (e) infiltrative growth of Gleason GG3 prostatic adenocarcinoma on a systematic core in the 3rd biopsy. Gleason pattern 3 is comprised of well-formed glands with relatively clear cytoplasm, small nuclei, and inconspicuous nucleoli. Gleason pattern 4 is made up of smaller, poorly formed glands with amphophilic cytoplasm, larger nuclei, and variably prominent nucleoli; (f) a radical prostatectomy specimen showing two distinct patterns of prostatic adenocarcinoma (the majority of Gleason pattern 3 and small population of pattern 4).
case_images: CRIU2021-2687416.001.jpg
case_images: PMC8054861_03_CRIU2021-2687416.001.jpg
case_images: fig1
case_images: A repeat mpMRI in 2018 demonstrated a stable 1.5 cm PI-RADS 5 lesion within the transition zone (Figures 1(b) and 1(c)). Five of 12 systematic cores were positive with the maximum Gleason GG4 (one core, Figure 1(d)), followed by Gleason GG3 (one core, Figure 1(e)), and Gleason GG2 (two cores). The patient underwent robotic-assisted laparoscopic radical prostatectomy and bilateral pelvic lymph node dissection with pathology demonstrating Gleason GG2 acinar adenocarcinoma involving 20% of the gland (Figure 1(f)), positive perineural invasion, negative surgical margins, lymphovascular invasion, extracapsular extension, and 36 negative nodes (pT2 pN0).
case_images: PMC8054861_03
case_images: (a) A focus of Gleason GG2 prostatic adenocarcinoma on a targeted core in the 2nd biopsy; (b) T2-weighted image shows lenticular homogeneous moderately hypointense lesion (arrow) measuring 1.5 cm located in right anterior transitional zone in midgland, representative of Prostate Imaging Reporting and Data System category 5; (c) apparent diffusion coefficient map shows marked focal hypointensity (arrow); (d) a single focus of Gleason GG4 prostatic adenocarcinoma on a systematic core in the 3rd biopsy; (e) infiltrative growth of Gleason GG3 prostatic adenocarcinoma on a systematic core in the 3rd biopsy. Gleason pattern 3 is comprised of well-formed glands with relatively clear cytoplasm, small nuclei, and inconspicuous nucleoli. Gleason pattern 4 is made up of smaller, poorly formed glands with amphophilic cytoplasm, larger nuclei, and variably prominent nucleoli; (f) a radical prostatectomy specimen showing two distinct patterns of prostatic adenocarcinoma (the majority of Gleason pattern 3 and small population of pattern 4).
case_images: CRIU2021-2687416.001.jpg
case_images: PMC8054861_03_CRIU2021-2687416.001.jpg
case_images: fig1
case_images: A repeat mpMRI in 2018 demonstrated a stable 1.5 cm PI-RADS 5 lesion within the transition zone (Figures 1(b) and 1(c)). Five of 12 systematic cores were positive with the maximum Gleason GG4 (one core, Figure 1(d)), followed by Gleason GG3 (one core, Figure 1(e)), and Gleason GG2 (two cores). The patient underwent robotic-assisted laparoscopic radical prostatectomy and bilateral pelvic lymph node dissection with pathology demonstrating Gleason GG2 acinar adenocarcinoma involving 20% of the gland (Figure 1(f)), positive perineural invasion, negative surgical margins, lymphovascular invasion, extracapsular extension, and 36 negative nodes (pT2 pN0).