Ultrasound report with possible gallbladder mass ABDOMEN:LIVER, BILIARY TRACT: Involving the gallbladder (see image 27 series 5) an corresponding to the masslesion seen on prior sonography is a hepatic segment 5/6 centrally necrotic mass measuring 5.9 x 4.8 cm. Mass is heterogeneous in appearance and demonstrates mild T2 hyperintensity. Mass demonstrates progressive postcontrast enhancement, suspicious for cholangiocarcinoma (see image 55 series 1501 and image 58 series 1/5/2004). No rounded T2 hypointense signal seen at level of gallbladder or mass to suggest underlying stone in when comparison made to prior ultrasound studies, there was no evidence of cholelithiasis. Gallbladder overall contracted and significant portion involved by tumor. Mild intrahepatic and extrahepatic biliary duct dilatation without definite distal CBD stone seen, see image 19 series 4. Metastatic lymphadenopathy present. Precaval lymph node measuring 2.8 x 2 cm, image 28 series 5. 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: Left para-aortic lymph node measuring 2.2 x 1.6 cm. Other smaller lymph nodes also seen, see image 89 series 1501.BOWEL, MESENTERY: Mass located in close proximity to hepatic flexure of colon (see image 69 series 1503), no definite underlying invasion but early serosal invasion not excluded, no upstream bowel dilatation seen to suggest obstruction. On coronal image 20 series 4, intervening fat plane between hepatic flexure of colon and liver preserved in appearance.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Findings compatible with gallbladder/liver mass as described, appearance suspicious for primary gallbladder adenocarcinoma (although no associated gallstone depicted). Given the progressive postcontrast enhancement demonstrated, cholangiocarcinoma is another concern. Upper abdominal/retroperitoneal lymphadenopathy present. Metastatic disease a differential consideration as well but considered less likely. 2. Mass situated in close proximity to hepatic flexure of colon, no definite underlying invasion but early serosal invasion not excluded. No bowel obstruction. 