PMC4904708_01
T2-weighted axial MRI at the level of the pubic symphysis demonstrating a T2 low signal intensity lesion adjacent to the right peripheral zone of the prostatic apex measuring 1.7 x 1.4 cm (arrow).
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The nodule appeared to be extracapsular and extraprostatic and appeared to involve the rectal submucosa and stretch the overlying rectal serosa and muscularis propria at 11 o'clock (Figure 1). The nodule was located approximately 6 cm cranial to the anal verge.
Transrectal ultrasound of the prostate gland. Image taken before core biopsy demonstrates a well-circumscribed lesion on the right, which is more convincingly extracapsular to the prostate gland and contains echogenic internal echoes (callipers).
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Ultrasound confirmed a well-circumscribed lesion at the right apex, which was more convincingly extraprostatic and rectal in origin (Figure 2). 18-gauge core biopsy of this lesion was performed, as well as 12 systematic core biopsies of the prostate gland.
Low power view of the edge of the neoplasm demonstrating that it is sharply demarcated from normal rectal muscle (black arrow) and consists of interlacing fascicles of spindle cells with elongated nuclei (broken black arrow) (haematoxylin and eosin x200).
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Histological analysis of this nodule demonstrated almost complete replacement of the needle cores by a low-grade spindle cell mesenchymal neoplasm (Figure 3).