Findings:
Quality: apex of the prostate cut off in axial T2-weighted and DWI images, does not compromise diagnostic confidence
Prostate size: 71 x 46 x 56 mm (CC x AP x ML) ≈95 mL, PSA density ~0.06 ng/mL2
Haemorrhage: diffuse subacute haemorrhage in the apical and midglandular peripheral and transitional zone right>left with inhomogeneously intermediate to low signal on T2-weighted images with interspersed areas of high signal and high signal in T1-weighted images
Peripheral zone (PZ): diffusely hypointense bilaterally with broad capsular contact and some residual heterogeneous signal in the right basal and midglandular anterior zones
Transition zone (TZ):
central periurethral defect after transurethral resection of the prostate (TURP)
some BPH nodules in the midglandular anterior transition zone (TZa)
diffuse homogeneous moderate hypointense signal in the midglandular and basal posterior transition zone (TZp) with obscured/indistinct pseudocapsule
Prostate margin: highly irregular with a capsular breach and tumour extension
Neurovascular bundles: asymmetry and invasion of the left neurovascular bundle
Seminal vesicles: extension of T2w hypointensity and diffusion restriction along the ejaculatory ducts above the base and within the inferior portion of the left seminal vesicle, bleeding in the mid and lateral portions of left seminal vesicle
Lymph nodes: suspicious, enlarged left external iliac lymph node
Pelvic bones: no signs of bony metastasis
Impression:
Histologically proven prostate cancer post transurethral resection of the prostate (TURP), with infiltration of both lobes from basal to apical with extraprostatic extension (EPE) and left seminal vesicle invasion (SVI).
Extensive prostatic haemorrhage predominantly in the apical and posterior midglandular zones.
MRI putative stage: cT3bN1Mx