History of HCC status post TACE/RFA, follow-up. ABDOMEN:LIVER, BILIARY TRACT: The liver demonstrates a cirrhotic morphology and loss of signal on in phase imaging compatible with iron deposition. Stigmata of portal hypertension are present including splenomegaly, gastroesophageal varices, and a recannulized periumbilical vein.In segment 3, there is a 2.7 x 1.6 cm post ablation halo (series 9, image 36) which demonstrates intrinsic T1 hyperintensity and which lacks residual arterial enhancement. Several scattered arterial enhancing foci become isointense on delayed imaging likely represent perfusional anomalies. No new suspicious arterially enhancing lesions which demonstrate washout are identified. Multiple simple hepatic cysts appear unchanged.The hepatic vessels appear patent. Portal vein is enlarged compatible with portal hypertension.There is cholelithiasis without evidence of cholecystitis. No biliary ductal dilatation.SPLEEN: Marked splenomegaly with spleen measuring 21 cm in the craniocaudal dimension, unchanged. Splenic hilar collateral vessels.PANCREAS: Multiple T2 hyperintense lesion within the pancreas most which appear to communicate with the main pancreatic duct and likely represent side branch IPMNs. The largest lesion is in the pancreatic body/tail (series 4, image 20) measuring 1.1 x 1.6 cm, unchanged compared to 8/21/2015 but slightly increased in size from 6/26/2014. The lesion lacks associated suspicious imaging features. The main pancreatic duct is normal in caliber.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Several bilateral small simple renal cysts. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Persistent trace right pleural effusion and basilar atelectasis. Right lower lobe pulmonary nodule is more fully characterized on chest CT from same day.
1.Stable post ablation findings of segment 3 hepatic lesion without evidence of residual or recurrent disease. No new suspicious lesions.2.Cirrhosis with portal hypertension.3.Cystic pancreatic lesions likely representing side branch IPMNs stable since 8/7/2015 but slightly increased in size from 6/26/2014.