75-year-old male patient with history of PSC and lymphadenopathy. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology with mildly irregular biliary ducts are again noted. There is questionable nonspecific delayed enhancement in a heterogeneous area of the right lobe of the liver (series 13 image 27) without corresponding diffusion signal abnormality. Attention should be paid to this area on subsequent imaging. Portal venous system is patent. Multiple gallbladder stones and sludge.SPLEEN: Splenomegaly, measuring up to 17 cm in craniocaudal dimension.PANCREAS: Evaluation of the pancreas is limited due to intra-abdominal ascites. Multiloculated cystic lesion in the uncinate process appear similar compared to prior examination and currently measures 1.1 x 1.4 cm (coronal series 5 image 65), previously 1.1 x 1.5 cm.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Reference upper abdominal retroperitoneal lymph node measures 3.9 x 1.3 cm (series 3 image 18), previously 3.9 x 1.5 cm. Other nonindex retroperitoneal lymph nodes appear unchanged compared to prior.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral gynecomastia is noted.OTHER: No significant abnormality noted.
1.No significant interval change in retroperitoneal lymphadenopathy.2.Questionable delayed enhancement in a heterogeneous area of the right lobe of the liver without definitive liver lesion. Attention should be paid to this area on subsequent examinations.3.Stable appearance of the biliary tree, compatible with history of sclerosing cholangitis, without new dominant stricture evident or new intrahepatic biliary dilatation.4.Stable multiseptated uncinate process probable pancreatic IPMN.