Reason: Evaluate for HCC History: HCV cirrhosis, elevated AFP ABDOMEN:LIVER, BILIARY TRACT: There is a dominant focal hepatic lesion at the junction of segments 5 and 6 with reference measurements as below. The lesion demonstrates increased T2 signal, restricted diffusion, decreased T1 signal, and predominantly peripheral enhancement. There is an additional similar smaller lesion at the hepatic dome at the junctions of segments 7 and 8 with reference measurements below. This lesion mildly attenuates the right hepatic vein which remains patent. No additional focal hepatic lesions are identified.The gallbladder appears within normal limits. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Simple right renal cyst. RETROPERITONEUM, LYMPH NODES: Few mildly prominent nonspecific periportal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.INDEX LESION MEASUREMENTS (Current exam date/time: 11/29/2016 10:30:00)HEPATIC SEGMENT 5/6 LESION: 3.5 x 4.1 cm (Image 270, Series 10).HEPATIC SEGMENT 7/8 LESION: 2.1 x 1.9 cm (Image 288, Series 10).
Two focal hepatic lesions which are highly suspicious for neoplasm. The lesions do not meet diagnostic criteria for HCC. Top differential considerations include cholangiocarcinoma, metastatic adenocarcinoma, or undifferentiated carcinoma.Findings discussed with BOYLE, ELIZABETH at 2:15 PM on 11/29/2016.