Fig. 6

A 47-year-old patient post-total colectomy for ulcerative colitis and elevated PSA. MP-MRI was performed to evaluate for potential tumour and to plan a biopsy. Axial T2W TSE (a) image demonstrates enlargement of the central gland (TZ) consistent with BPH. There is a well-circumscribed, round, mixed but predominantly increased T2W SI nodule with internal cystic change (white arrow) and a predominantly homogeneously low T2 SI nodule at the junction of the right middle PZ and central gland (dotted arrow). The larger nodule demonstrates T2 shine-through on the ADC map (black arrow in b) and is characteristic of glandular BPH. The other nodule demonstrates restricted diffusion (thick black arrow in b) and type III kinetics at DCE (c). A diagnosis of prostate cancer was suggested. Targeted biopsy revealed normal prostatic tissue and stromal BPH. Follow-up MRI (not shown) demonstrated no change and the PSA was stable. In retrospect, the nodule is round, well-circumscribed and demonstrates a complete low T2 SI rim (a), findings that are more in keeping with stromal BPH rather than cancer