History of primary sclerosing cholangitis. Evaluate for concerning lesion. ABDOMEN:LIVER, BILIARY TRACT: There is mild left liver lobe atrophy. There is multifocal bilobar left greater than right irregular stricturing and dilatation of the intrahepatic bile ducts and the common bile duct consistent with primary sclerosing cholangitis. This most prominently involves the lateral segment of the left hepatic lobe, but this is improved from the prior study, for example, duct measuring up to 5 mm today, compared to 7 mm previously. No underlying lesion is evident on today's study. No new dominant stricture or discrete mass lesion is evident. Segment 5 subcentimeter simple hepatic cyst. Normally distended gallbladder. The vessels are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post left nephrectomy with susceptibility artifact in the nephrectomy bed. No evidence of residual recurrent tumor in the nephrectomy bed.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Redemonstrated multifocal areas of severe dilatation and stricturing of the intra and extrahepatic biliary tree most pronounced in the left lobe laterally appearing slightly improved from the prior study without a discrete masslesion evident. An underlying masslesion cannot be entirely excluded but the interval mild decrease in bile duct dilatation favors a benign PSC stricture.