34-year-old male with primary sclerosing cholangitis, evaluate for cholangiocarcinoma. ABDOMEN:LIVER, BILIARY TRACT: There are moderate multifocal areas of narrowing of the intrahepatic biliary ducts compatible with history of primary sclerosing disease. A biliary walls are mild thickening and hyper enhancing throughout the intra and extrahepatic biliary system. Specifically, the right intrahepatic biliary wall is thickened and enhancing. The common bile duct measures 6 mm in diameter with irregularity along its course. There is severe stricturing distally (5/46) and mild stricturing along the midportion.No suspicious hepatic lesions to suggest cholangiocarcinoma.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: There are multiple enlarged peripancreatic lymph nodes, adjacent to the common bile duct, measuring up to 2.0 x 2.8 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Intrahepatic and extrahepatic biliary strictures compatible with history of primary sclerosing cholangitis.2.Biliary walls are thickened and hyperenhancing, which may represent cholangitis.3.No specific evidence of cholangiocarcinoma.4.Multiple enlarged peripancreatic lymph nodes.