Prostate cancer has come to share the oncological centrestage among male cancers. The availability of Serum Prostate Specific Antigen, PSA, as a marker has encouraged it's use to diagnose both cancer and cancer recurrence. Some clarity is required about its precise role in clinical practice. The available literature on Prostate Specific Antigen was reviewed; Articles were reviewed for content, applicability to the problem at hand, availability of data about sensitivity and specificity of values, refinements in measurements and finally for impact of screening programmes using these values on survival and quality of life. The data in the literature was critically re-evaluated and analysed to draw reasonable conclusions. Serum PSA measurements show variable reliability when it comes to diagnosis of Prostate cancer, given the dynamics of PSA physiology. Surrogate measures like PSA density, PSA velocity, free-to-complexed PSA ratio, percentage Pro-PSA, etc., have been used to improve the predictive utility of this assay for Prostate cancer. The ability of PSA to detect those cancers that will cost life, and thereby permit early curative treatment, is as yet unclear. It's most definitive role appears to be in diagnosing recurrences after adequate surgical treatment, and in evaluating response to treatment.

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Primary lymphoma involving the prostate gland is rare. It accounts for 0.09 % of prostatic malignancies [1]. It commonly presents in the seventh decade with Lower Urinary Tract Symptoms (LUTS). Diffuse large B cell lymphoma is the common pathological variant [2]. Chemotherapy and radiotherapy are the common modalities of treatment and the overall prognosis is poor [2]. We present a 26 year old HIV infected patient - on anti-retroviral therapy who presented with acute renal failure and grossly enlarged prostate. Prostate biopsy with immuno-histochemistry confirmed the diagnosis of Peripheral T-cell lymphoma. He was treated with Adriamycin based chemotherapy and radiotherapy. We report this case in view of the rarity the tumor, younger age at presentation than that is available in literature and the pathological variant not reported in primary prostatic lymphoma.