Female 66 years old with history of marginal zone lymphoma s/p rituximab treatment and chondrosarcoma s/p resection with possible metastatic liver lesions on recent CT. Evaluate and comment on potential for accessibility for biopsy. ABDOMEN:LIVER, BILIARY TRACT: The liver measures 19 cm in length and smooth in contour.A 1.5 x 0.8 cm T2 hyperintense lesion in hepatic segment 7 has progressive, peripheral, nodular discontinuous enhancement consistent with hemangioma. An additional subcentimeter T2 hyperintense lesion laterally in segment 7 fills in on postcontrast images also consistent with hemangioma. A 0.9 x 0.9 cm T2 hyperintense lesion in segment 6 shows minimal peripheral enhancement on delayed images, it is too small to accurately characterize but hemangioma is favored.No intra or extrahepatic biliary ductal dilatation. The hepatic vasculature appears patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Nodular thickening of the left adrenal gland is nonspecific and unchangedKIDNEYS, URETERS: Nonobstructing left renal calculus. There are a few bilateral simple renal cysts and additional renal lesions too small to accurately characterize. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a small duodenal diverticulum. Colon diverticulosis, no evidence of acute diverticulitis.BONES, SOFT TISSUES: T2 hyperintense, enhancing lesion are seen in the T9 and L1 vertebral bodies consistent with hemangiomas. Postsurgical changes are seen along the anterior abdominal wall.OTHER: No significant abnormality noted.
1.The two previously described segment 7 lesions have imaging characteristics of hemangiomas. The segment 6 lesion is too small to accurately characterize but is also favored to represent hemangioma. No suspicious hepatic lesions.2.Nonobstructing left renal calculus.