PMC9941543_01
(A) [68Ga]Ga-PSMA-11 PET Maximum-Intensity-Projection - MIP; (B) prostate gland at axial-PSMA-PET fused with previous mpMRI axial T1-Lava sequence; (C) prostate gland at mpMRI, coronal view, T2 sequence; (D) right external iliac lymph-node uptake at axial PSMA-PET fused with previous mpMRI; (E) bone lesion at L3 vertebral body with osteoblastic pattern and multiple lumbar-aortic lymph-nodes at axial fused PSMA-PET/CT; (F) left axillary lymph-node uptake at axial fused PSMA-PET/CT.
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The [68Ga]Ga-PSMA-11 PET/CT did not show any significant area of focal uptake within the prostate gland (SUVmax=3.6; (A,  Figure 1 ) orange circle and (B) orange arrow), neither at a 90 minutes-delayed scan; that was in accordance with the previous mpMRI (C) showing PI-RADS 2 prostate gland ( Figure 2 ). Figure 1  ) purple circle and (D) purple arrow, showing an avid right external iliac lymph-node; (E) showing multiple lumbar-aortic lymph-nodes). Further findings were also detected: a single, intense focal bone lesion at L3 vertebral body with osteoblastic pattern (SUVmax=14; (A) yellow circle, (E) yellow arrow) and a single focal uptake in a left axillary lymph-node (SUVmax=19; (A) blue circle; (F) blue arrow).
(A) PI-RADS 2 prostate gland at mpMRI, ADC, axial; (B) PI-RADS 2 prostate gland at mpMRI, DWI, axial; (C) PI-RADS 2 prostate gland at mpMRI, T2, axial; (D) external iliac enlarged lymph node showing contrast-enhancement at mpMRI, T1 LAVA FLEX sequence, axial.
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The [68Ga]Ga-PSMA-11 PET/CT did not show any significant area of focal uptake within the prostate gland (SUVmax=3.6; (A,  Figure 1 ) orange circle and (B) orange arrow), neither at a 90 minutes-delayed scan; that was in accordance with the previous mpMRI (C) showing PI-RADS 2 prostate gland ( Figure 2 ).
H&E staining, showing axillary lymph node biopsy with neoplastic cells with eosinophilic cytoplasm (A). At immunohistochemistry cells resulted positive for NKX3.1 (B) and androgen receptor (C) with nuclear positivity for both antibody and for PSA (D) cytoplasmatic positivity. They resulted negative for synaptophysin, chromogranin and CK7.
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Immunohistochemistry was also performed ( Figure 3 ).