54-year-old female with reportedly newly diagnosed HCC, evaluate extent of disease/cirrhosis ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. Mildly cirrhotic liver morphology.There is a lesion within the inferior aspect of segment 6 measuring 5.7 x 7.4 cm which is hyperintense on DWI and T2 and hypointense on T1-weighted images. Following contrast administration no definite hyperenhancement on arterial phase images is evident. Progressive delayed enhancement is suggested within the lesion, may reflect underlying fibrous composition. This lesion is hypointense on delayed phase images. A branch of the right portal vein leading to the lesion is thrombosed.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: Multiple enlarged portacaval nodes measuring 3.1 x 1.8 cm (13/38) and 3.8 x 2.5 cm (13/49)BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Basilar pulmonary opacities.
Outside exam read:1.Cirrhotic liver morphology with large segment 6 lesion. There is no definite hyperenhancement on arterial phase images (which would favor a hepatocellular carcinoma). Cholangiocarcinoma is favored given apparent progressive delayed enhancement within lesion, however remaining among differential considerations are an atypical hepatocellular carcinoma or hypovascular metastatic disease.2.Thrombosis of a branch of the right portal vein.3.Enlarged portacaval lymph nodes.