73-year-old male patient with cholangiocarcinoma/HCC mixed status post chemotherapy. Evaluate for interval change. ABDOMEN:LIVER, BILIARY TRACT: There is hypertrophy of the caudate and left hepatic lobe with deepening of the fissures, suggestive of chronic liver disease.A lesion within segment 5 which demonstrates enhancement and washout on delayed phases is grossly stable in size measuring 4.5 x 4.2 cm (image 149, series 11), previously 4.5 x 4.6 cm. A segment 4A/8 lesion which demonstrates capsular retraction is similar in size to the prior study measuring 4.7 x 2.8 cm (image 34, series 10). This lesion has an enhancing nodular component which demonstrates washout and more peripheral components that demonstrate progressive enhancement.A previously described hypoenhancing segment 4A lesion is smaller in size now only a small focus of T2 hyperintensity without diffusion abnormality. Numerous additional T2 hyperintense lesions throughout both hepatic lobes are stable in size. No new lesion is identified. 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: An enlarged portocaval lymph node has increased in size measuring 3.7 x 2.0 cm (image 26, series 3), previously 3.0 x 1.6 cm. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Grossly stable size of a segment 4A/8 lesion with capsular retraction with imaging findings compatible with HCC and possibly cholangiohepatoma. 2.Grossly stable size of a segment 5 lesion with imaging characteristics of HCC.3.Decreased size of a segment 4A lesion and stable appearing T2 hyperintense hepatic lesions. 4.Enlarging portocaval lymph node.