Newly diagnosed cholangiocarcinoma. Evaluate for metastases. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in size. There is abnormal soft tissue infiltration along the porta hepatis into the central hepatic parenchyma and infiltrating segment 5 of the liver. There is severe right hepatic lobe biliary ductal dilatation. There are additional satellite lesions in the right hepatic lobe (including series 8, image 55, 56).The common bile duct is essentially obliterated by the periductal tumor with associated intrahepatic biliary ductal dilatation.Hydropic gallbladder containing numerous gallstones. Nonspecific pericholecystic fluid. No significant gallbladder wall thickening.A biliary stent is noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderate volume ascites. Perihepatic soft tissue nodule suspicious for peritoneal carcinomatosis, see measurement below.BONES, SOFT TISSUES: Mild anasarca. Well-defined hypoechoic uterine masses likely represents fibroids.OTHER: No significant abnormality noted.
1. Extensive soft tissue infiltration along the porta hepatis and into the right hepatic lobe with associated suspected hepatic satellite metastases compatible with the stated history of cholangiocarcinoma. Associated marked right hepatic lobe biliary ductal dilatation.2. Hydropic gallbladder with cholelithiasis.INDEX LESION MEASUREMENTS (Current exam date/time: 1/11/2016 22:00:00)PERIHEPATIC SOFT TISSUE NODULE: 1.2 x 1.0 cm (Image 151, Series 8).INFILTRATING PORTAHEPATIS MASS: 10.8 x 5.1 cm (Image 143, Series 8).