Biliary obstruction. Abdominal pain. History of ovarian/fallopian cancer. ABDOMEN:LIVER, BILIARY TRACT: Fatty liver. Numerous bilobar mildly and very hyperintense subcentimeter lesions in the liver. The number, distribution and enhancement characteristics suggest that this is primarily biliary hamartomas. No extra hepatic biliary ductal dilatation. There is moderate bilobar intrahepatic ductal dilatation with abrupt narrowing of the common hepatic duct (series 401/24) at the level of the patient's porta hepatis lymphadenopathy.Mild narrowing of the extrahepatic portal vein. Moderate to severe narrowing of the left portal vein.SPLEEN: The spleen measures 13.8 cm in craniocaudal length with a small non-specific hypoenhancing focus.PANCREAS: Pancreas divisum without pancreatic ductal dilatation or focal lesion.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate bilateral T2-weighted hyperintensities, probable cysts.RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal lymphadenopathy. Porta hepatis lymphadenopathy. Extensive peripherally enhancing serosal implants along the falciform ligament, of the left lobe of the liver and posterior aspect of the antrum. Portocaval lymphadenopathy.BOWEL, MESENTERY: There is moderate volume of loculated ascites with thin septations suspicious for peritoneal carcinomatosis. Nodular implants along the greater curvature of the stomach, better evaluated on recent CT.BONES, SOFT TISSUES: Metastatic pulmonary nodules are partially imaged. Small right anterior abdominal hernia containing a short-segment or wall of small bowel, unchanged.OTHER: No significant abnormality noted.
Intrahepatic biliary ductal dilatation to the level of the common hepatic duct where there is porta hepatis lymphadenopathy as well as tumoral implants. Numerous punctate liver lesions likely represent multiple biliary hamartomas. Mild narrowing of the extrahepatic portal vein. Moderate to severe narrowing of the left portal vein.Peritoneal carcinomatosis including moderate volume of loculated ascites and serosal implants along the stomach and liver. 