Reason: history of right upper quadrant pain, possible cirrhosis?, rule out cbd stone, cholecystitis, pancreatic mass, hepatic mass History: right upper quadrant pain. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology. Geographic areas of T2 hyperintense signal and arterial hyperenhancement involving segments 4, 5, 8, and some of 2, with associated retraction compatible with advanced focal confluent fibrosis. Two foci within segment 5 and 8 within these areas of fibrosis demonstrate delayed washout (1604 images 60 and 71). For future reference, the largest focus measures 3.1 x 3.7 cm (series 1601 and 1604 image 60). Small subcentimeter cyst in the left lobe. The gallbladder is mildly distended. No gallstone, pericholecystic fluid or gallbladder wall thickening. Extrahepatic biliary ductal dilatation. The common bile duct measures up to 1.1 centimeters (series 10 image 98) with gradual tapering to the ampulla. No filling defect identified. Small amount of perihepatic ascites.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic duct is dilated measuring 0.7 cm (series 10 image 51) with gradual tapering to the ampulla. No pancreatic mass identified.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Cirrhotic morphology with advanced confluent fibrosis. Within this fibrosis in segments 5 and 8, there are two foci of delayed wash out. While, this is unusual for HCC, recommend short term follow up in 3-4 months to confirm stability. 2.Dilated common bile and pancreatic ducts, which gradually taper to the ampulla without filling defects or obstructing mass. 3.Mildly dilated gallbladder again noted without other evidence of acute cholecystitis. 