78 year old male with metastatic colon cancer in lung and liver. Staging. CHEST: LUNGS AND PLEURA: Scarlike opacities and postsurgical changes are seen in both lungs. In the left upper lobe, there is a 1.5 x 1.4 cm nodule consistent with metastatic disease. A smaller and more irregularly shaped nodule in the right lower lobe measures 1.1 x 1.4 cm, consistent with a metastasis. Small right pleural effusion has resolved. MEDIASTINUM AND HILA: Atherosclerotic calcifications in the thoracic aorta and coronary arteries. Normal heart size. No pericardial effusion. Borderline enlarged right hilar lymph node. Small mediastinal lymph nodes.CHEST WALL: Right chest wall Port-A-Cath with the tip in the superior vena cava. There is possibly partial collapse of the L1 vertebral body which is incompletely visualized on this study. Right-sided venous access device is in expected position.ABDOMEN:LIVER, BILIARY TRACT: Intra- and extra-hepatic biliary ductal dilatation to the level of the ampulla. No obstructing mass is identified.Large mass noted in the right lobe of the liver without enhancement. This mass has an exophytic component. It measures 4.7 x 7.7 cm (image 82, series #3). A second, smaller lesion with similar characteristics is noted inferior to the dominant mass that also is compatible with a metastasis. Additional, subcentimeter lesions are scattered throughout the liver with typical features of benign cysts on the MRI exam. Cholelithiasis noted.SPLEEN: No significant abnormality noted. Calcified splenic granulomata. PANCREAS: Prominent pancreatic duct.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Compression deformity at the superior endplate of L1.OTHER: IVC filter is in the expected position. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Sigmoid diverticulosis. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Benign calcifications in the left groin and left spermatic cord.
1. Minimal intra- and extra-hepatic biliary ductal dilatation to the level of the ampulla. No obstructing mass is identified; however, cannot rule out obstructing ampullary stricture.2. Hepatic metastases are stable since the prior MRI exam.