53 year old female with alcoholic cirrhosis and HCC status post resection presenting with right upper quadrant pain. Evaluate for recurrence. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver has nodular contours consistent with cirrhosis. New hyperattenuating focus seen only on arterial phase measures 1 x 1 cm on image 39 series 9. Although no definite washout is identified which favors benignity, continued follow up or MRI is suggested for further characterization of this lesion. The patient has undergone interval resection of a portion of the left lateral segment. There is a small perihepatic fluid collection which is likely postsurgical in etiology. No new lesions are identified.Cholelithiasis and pericholecystic fluid. If there is clinical concern for acute cholecystitis, a right upper quadrant ultrasound may be obtained. 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: Borderline enlarged retroperitoneal lymph nodes are stable.BOWEL, MESENTERY: Appearance of intussusception in the duodenum may be transient and is of uncertain clinical significance. Multiple colonic diverticula with retained hyperattenuating foci likely represent retained contrast. No evidence of obstruction, intra-abdominal free air, or abscess is identified.BONES, SOFT TISSUES: Postsurgical changes are identified in the right anterior abdominal wall from the incision.OTHER: Extensive collateral vessels inferior to the spleen at the splenic hilum consistent with portal hypertension.
1.New 1 cm enhancing focus in the right lobe of liver seen only on arterial phase without definite washout for which continued follow-up or MRI for further characterization is suggested. 2.Cirrhosis and portal hypertension as described above.3.Cholelithiasis and pericholecystic fluid. If there is clinical concern for acute cholecystitis, a right upper quadrant no may be obtained.4.Postoperative and other findings as described above.