Posted 9/8/2016 6:29 AM (GMT 0)
Bololidat,
My husband is going to get hip xrays.
Here are the biopsy and ct scan reports.
Surgical Pathology Report
FINAL PATHOLOGIC DIAGNOSIS
A. PROSTATE, RIGHT BASE, NEEDLE BIOPSY:
- PROSTATE ADENOCARCINOMA, GLEASON GRADE 4+5, INVOLVING 2 OF 2
CORES, WITH PERINEURAL INVASION, AND INVLOVING about 90% OF THE
ENTIRE BIOPSY SPECIMEN.
B. PROSTATE, RIGHT MID, NEEDLE BIOPSY:
- PROSTATE ADENOCARCINOMA, GLEASON GRADE 4+5, INVOLVING 2 OF 2
CORES, WITH PERINEURAL INVASION, AND INVLOVING about 80% OF THE
ENTIRE BIOPSY SPECIMEN.
C. PROSTATE, RIGHT APEX, NEEDLE BIOPSY:
- PROSTATE ADENOCARCINOMA, GLEASON GRADE 4+4, INVOLVING 1 OF 2
CORES, WITH PERINEURAL INVASION, AND INVLOVING about 15% OF THE
ENTIRE BIOPSY SPECIMEN.
D. PROSTATE, LEFT BASE, NEEDLE BIOPSY:
- PROSTATE ADENOCARCINOMA, GLEASON GRADE 4+5, INVOLVING 2 OF 2
CORES, WITH PERINEURAL INVASION, AND INVLOVING about 80% OF THE
ENTIRE BIOPSY SPECIMEN.
E. PROSTATE, LEFT MID, NEEDLE BIOPSY:
- PROSTATE ADENOCARCINOMA, GLEASON GRADE 4+5, INVOLVING 2 OF 2
CORES, WITH PERINEURAL INVASION, AND INVLOVING about 70% OF THE
ENTIRE BIOPSY SPECIMEN.
F. PROSTATE, LEFT APEX, NEEDLE BIOPSY:
- PROSTATE ADENOCARCINOMA, GLEASON GRADE 4+4, INVOLVING 2 OF 2
CORES, WITH PERINEURAL INVASION, AND INVLOVING about 70% OF THE
ENTIRE BIOPSY SPECIMEN.
G. PROSTATE, TRANSITION ZONE, NEEDLE BIOPSY:
- PROSTATE ADENOCARCINOMA, GLEASON GRADE 4+5, INVOLVING 2 OF 2
CORES, AND INVLOVING about 65% OF THE ENTIRE BIOPSY SPECIMEN.
** FINDINGS **:
Comparison: 08/19/2011
Technique: CT images of the abdomen and pelvis were obtained after
the administration of 115 mL Omnipaque 300 IV contrast.
Multiplanar reformats created.
CTDI: 10.17 mGy
DLP: 460.15 mGy-cm
5 mm calcified granuloma again demonstrated in the lingula of the
left lung, unchanged. Imaged lung bases are otherwise unremarkable
except for mild atelectasis/scarring. Heart size is normal.
Cholelithiasis without evidence of cholecystitis. Small hepatic
cyst in the right hepatic dome measuring approximately 12 mm,
unchanged. No suspicious liver enhancement. Too small characterize
subcentimeter hypodensity medially in the right hepatic lobe,
likely small cyst or hemangioma. A few other smaller hypodense
lesions are again seen, too small for further characterization,
but unchanged and likely benign cysts or hemangiomas. Pancreas,
spleen, and adrenal glands are unremarkable.
Evaluation of the renal collecting systems and ureters is limited
by lack of excretory phase imaging. Interval development of severe
left hydronephrosis and left hydroureter with soft tissue
thickening/obstruction of the distal left ureter, suspicious for
distal left ureteral malignancy with possible involvement of the
adjacent bladder near the left UVJ. Abnormal suspicious soft
tissue thickening in the distal left ureter measures approximately
1.9 x 1.0 x 1.1 cm. 2 small calcifications are demonstrated
dependently in the dilated left ureter in the left pelvis
measuring up to 4 mm, best demonstrated on coronal image 32,
consistent with small ureteral stones or ureteral wall
calcifications.
Prostate is irregular and enlarged measuring approximately 6.6 x
5.2 x 4.8 cm with irregular mass effect upon the base of the
bladder. Potential extension of patient's known prostate cancer
into the base of the bladder is not excluded. Prostate does not
extend to the pelvic sidewalls. Right seminal vesicle is
heterogeneous and thickened measuring approximately 2.3 cm in AP
diameter, nonspecific, but suspicious for potential prostate
cancer involvement. Left seminal vesicle is not enlarged,
nonspecific in appearance. No inguinal adenopathy.
Periaortic adenopathy is demonstrated in the lower abdomen and
upper abdomen. Enlarged representative nodes include a suspicious
1.5 cm node positioned between the aorta and IVC, series 3 image
41 and a 15 mm enlarged node adjacent to the aortic inferior to
the left renal artery and vein.
Right renal cortex enhances normally with no renal cortical mass
demonstrated. No right hydroureter demonstrated.
Bones are nonspecific with multilevel degenerative changes. No
discrete CT evidence of bony metastasis. A 1.5 cm probable
hemangioma in the T11 vertebral body is unchanged.
Moderate diverticulosis coli without evidence of diverticulitis.
Small bowel and stomach are unremarkable.
Normal abdominal aortic diameter (<3cm).
** IMPRESSION **:
Prostate is irregular and enlarged measuring up to approximately
6.6 cm with irregular mass effect on the base of the bladder,
consistent with patient's known prostate cancer. Potential
extension of prostate cancer into the base the bladder is not
excluded. Right seminal vesicle is heterogeneous and thickened
measuring approximately 2.3 cm in AP diameter, nonspecific, but
suspicious for potential prostate cancer involvement. Clinical
correlation recommended.
Evaluation of the renal collecting systems and ureters is limited
by lack of excretory phase imaging. Interval development of severe
left hydronephrosis and left hydroureter with soft tissue
thickening/obstruction of the distal left ureter, suspicious for
distal left ureteral malignancy with possible involvement of the
adjacent bladder near the left UVJ. Abnormal suspicious soft
tissue thickening in the distal left ureter measures approximately
1.9 x 1.0 x 1.1 cm.
Further evaluation by cystoscopy is recommended.
Periaortic adenopathy in the upper and lower abdomen, as
described, suspicious for malignant involvement, as described.
No discrete CT evidence of bony metastasis, however nuclear
medicine bone scan is a more sensitive exam. Correlation with
whole body nuclear medicine bone scan recommended.
If clinically indicated, further evaluation by PET scan could be
obtained.
2 small calcifications are demonstrated dependently in the dilated
left ureter in the left pelvis measuring up to 4 mm, as described,
consistent with small ureteral stones or ureteral wall
calcifications.
He had the cystoscopy today and the urologist showed us the cancer.
He took a bunch of pictures.
Jacky and Steve