69-year-old female with AIH cirrhosis. HCC screening. ABDOMEN:LUNG BASES: Moderate right and small left pleural effusions, partially visualized. Small hiatal hernia.LIVER, BILIARY TRACT: Cirrhotic liver morphology with nodular surface contour and hypertrophy of the caudate and left lobes. No focal hepatic lesions. No biliary ductal dilation. Hepatic and portal veins are patent. Hepatic artery is patent. Small portosystemic shunts including esophageal varices noted. SPLEEN: Moderate splenomegaly with the spleen measuring up to 15.8 cm.PANCREAS: T2 hyperintense cystic focus in the anterior pancreatic body without mural nodularity or enhancement, measuring up to 18 mm craniocaudally (series 2/39). An additional smaller lesion is seen in the posterior pancreatic body, measuring up to 4 mm (series 7/23). These are most suspicious for small side branch IPMNs. Normal caliber of the main pancreatic duct measuring up to 1-2 mm.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: Mild body wall anasarca.OTHER: Moderate abdominal ascites.
1. Cirrhotic liver morphology without focal liver lesion.2. Findings suggestive of portal hypertension with splenomegaly, ascites, and small portosystemic shunts.3. Two cystic foci in the pancreatic body suspicious for small sidebranch IPMNs and for which follow-up imaging is recommended.4. Contrast extravasation occurred as detailed above.