Figure 5.

A 64-year-old patient on active surveillance with stable PSA. Transperineal biopsy 2 years prior showed 1/24 cores positive for Gleason 3+3 disease (<5%). No convincing lesion demonstrated in the prostate on MRI. T2-weighted imaging shows new adenopathy (A) with associated restricted diffusion (B,C) and heterogeneous bone marrow change. Nodal distribution involving inguinal nodes and iliac chains but not obturator regions. Nodal biopsy showed B-cell lymphoma with immunophenotype in keeping with CLL/SLL. MRI, magnetic resonance imaging; PSA, prostate-specific antigen; CLL, chronic lymphocytic leukemia; SLL, small lymphocytic lymphoma.