PMC9412233_01
Pelvic MRI and PET/CT. (A) Axial T1 weighted image (WI), (B) axial diffusion weighted image (DWI), (C) axial gadolinium-enhanced fat-saturated T1WI, (D) axial T2WI, (E) sagittal T2WI, and (F) axial T2WI. (G, H)
18F-FDG PET/CT. There is a giant unilocular cystic lesion measured 10.5 x 8.2 cm in size displacing the rectum ( ) to the posterior, prostate (*), and bladder ( ) to the anterior. It was hyperintense on T1WI and T2WI, without diffusion restriction nor enhancement. At the anterior wall, a 2.8 x 2.1 cm solid nodule with isointensity on both T1WI and T2WI, diffusion restriction and marked enhancement, was also noted. PET/CT demonstrated an elevated SUVmax (3.5) of the solid nodule. Please note the catheter in the bladder ( ). The thick arrow, the unilocular cystic lesion; the thin arrow, the solid nodule.
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Pelvic magnetic resonance imaging (MRI) revealed a 10.5 x 8.2 cm mono-cystic lesion displacing the rectum to the posterior, prostate, and bladder to the anterior, with a 2.8 x 2.1 cm solid nodule at the anterior wall ( Figure 1 , Supplement).
Pathological diagnosis of the mono-cystic mass. (A) HE staining slide shows branching papillary structure, lining benign double-layer prostatic epithelial cells (original magnification, x100); (B) The cells lining the cysts were strongly and uniformly positive for PSA (original magnification, x100); (C) Basal cells were immunohistochemical staining for high-molecular weight cytokeratin (34betaE12) (original magnification, x100); (D) Basal cells were immunohistochemical staining for p63 (original magnification, x100); (E) The gross specimen.
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Overall, the cells lining the cysts were strongly and uniformly positive for PSA and prostate specific membrane antigen (PSMA) and negative for P504S ( Figure 2 , Supplement). Basal cells were identified on light microscopy and with immunohistochemical staining for high-molecular weight cytokeratin CK34betaE12 and p63 ( Figure 2 , Supplement).