Diffuse large B-cell Lymphoma. Elevated transaminase and left acid dehydrogenase. Evaluate for cholestatic lesion amenable to ERCP stenting. Recent relapse with new diagnosis of metastatic lung cancer. Evaluation is limited by motion artifact on postcontrast series.ABDOMEN:LIVER, BILIARY TRACT: A numerable T2 hyperintense bilobar hepatic lesions are identified, probably secondary to lymphoma. There is abnormal enhancement within the left hepatic lobe, which may be due to a perfusion abnormality versus infiltrative disease. There is cut off of the proximal common bile duct (series 901, image 70). However the distal common bile duct is normal in caliber. No obstructing mass is identified.SPLEEN: No significant abnormality identified. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left lower pole renal cyst measures 2.2 x 2.1 cm, unchanged. The right kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes are identified.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate to large left pleural effusion with adjacent atelectasis.
1.Scattered bilobar T2 hyperintense lesions and abnormal enhancement within the left hepatic lobe, suspicious for infiltrative disease.2.Large left pleural effusion with adjacent atelectasis.3.Cutoff of the proximal common bile duct, with no distal ductal dilatation. No obstructing mass is identified.Findings discussed with Dr. Thoburn at 4:30PM on January 22, 2016.