The urinary bladder, trigoneand pelvic urethra presented normal wall thicknesses with anechoic urine and normal tone. No uroliths or sediment were visualized. No evidence of inflammatory or neoplastic changes were noted. The ureters were not visible and therefore considered normal.

The prostate in this patient presented a 4.0 cm mixed hypoechoic mineralizing mass.  Pericapsular inflammatory pattern was noted.  This is strongly consistent with prostatic carcinoma.  Stent placement would be warranted in this patient.  A subcutaneous hypoechoic mass was noted and measured 3.4 cm.  This is strongly suggestive for sarcoma.  Ultrasound guided FNA is also warranted.  The urethra was completely disrupted by the prostatic mass itself with focal areas of mineralization throughout both the lumen and the parenchyma.  Regional sublumbar lymph node was enlarged, hypoechoic, irregular with distorted length to width ratio and pericapsular inflammatory pattern.  This is strongly suggestive for metastatic disease.

The kidneys revealed largely normal size and structure, corticomedullary definition and ratio (cortex 1/3 of medulla) were essentially maintained with some age related loss of curvilinear patterns. The cortices presented largely uniform texture with some age related echogenic changes that are not likely of clinical significance at this time unless inflammatory sediment or proteinuria is present. Medullary echogenicity differed distinctly from that of the cortex and no evidence or dilation could be seen. The capsules were acceptably uniform for this age patient without dramatic irregularities. Slight hydronephrosis was noted in the right kidney.  The right kidney measured 4.4 cm, pyelectasia measured 0.28 cm.  The left kidney measured 5.08 cm.  Regional inflammation was noted.  Ultrasound guided FNA is warranted. Free fluid was noted which was owing to inflammation around the iliac lymph nodes and prostate.