Male 62 years old Reason: eval noted HCC from 9/11/14, 2.1cm lesion liver, pancreas lesion 1.3 History: HCC, HCV, pancreatic lesion ABDOMEN:LIVER, BILIARY TRACT: Signal dropout on in phase images suggestive of iron deposition. Hepatic cirrhosis as evidenced by left lobe hypertrophy and nodular hepatic contour. Heterogeneous T2 hyperintensity suggestive of hepatic fibrosis. Stable appearance of right hepatic lobe cysts.The previously described arterially enhancing lesion in segment 3 now measures 2.4 x 2.0 cm (series 13, Image 67), enlarged from previous study where it measured 1.8 x 1.7 cm. There is no convincing washout. It demonstrates mild T2 hyperintense signal and is bright on diffusion images. This is highly suspicious for hepatocellular carcinoma however it does not meet strict criteria in the absence of washout.Patent hepatic vasculature.Cholelithiasis. No intra-or extrahepatic biliary dilatation.SPLEEN: Severe splenomegaly measuring 21.1 cm.PANCREAS: Multiple T2 hyperintense lesions within the pancreas, which appear to communicate with the main pancreatic duct. The largest lesion in the pancreatic body/tail measures 1.3 x 0.9 cm (series 9, image 17), previously 1.3 x 1.2 cm. These likely represent side branch IPMNs.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: BIlateral renal cysts, unchanged. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild thickening and prominence of small bowel loops, likely secondary to chronic liver disease.BONES, SOFT TISSUES: No significant abnormality noted.
1.Enlarging segment 3 lesion as detailed above which is highly suspicious hepatocellular carcinoma however it does not meet strict criteria in the absence of washout.2.Liver cirrhosis with evidence of portal hypertension.3.Multiple T2 hyperintense pancreatic lesions, likely representing sidebranch IPMNs.