History of cholangiocarcinoma with elevated bilirubin and periportal lymphadenopathy. Evaluate for possible stent versus liver dysfunction as etiology of bilirubinemia. ABDOMEN:LIVER, BILIARY TRACT: Lobular mass centered in segment 4 extending to the lateral and medial segments of the liver measuring up to 9.1 x 8.5 cm in cross-section. There are multiple associated T2-weighted mildly hyperintense enhancing satellite lesions in both lobes of the liver. There is associated moderate intrahepatic biliary ductal dilatation involving the right hepatic lobe.Normally distended gallbladder with small gallstones.Moderate volume perihepatic ascites.SPLEEN: Mild splenomegaly measuring 14.5 cm in length. Trace perisplenic fluid.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mildly atrophic kidneys. Left renal simple appearing cyst.RETROPERITONEUM, LYMPH NODES: Several enlarged periportal lymph nodes.BOWEL, MESENTERY: Trace mesenteric fluid.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild dependent body wall edema.
Large central hepatic mass with multiple satellite lesions in both lobes of the liver. The mass causes moderate intrahepatic ductal dilatation in the right hepatic lobe. No central biliary ductal dilatation. Locoregional adenopathy present. Small volume ascites.