76-year-old woman with history of metastatic breast cancer and right upper quadrant abdominal pain. Dilated CBD on ultrasound. ABDOMEN:LIVER, BILIARY TRACT: There is intra and extrahepatic biliary duct dilatation with the distal common bile duct measuring up to 10 mm in diameter (series 4, image 15). The distal common bile duct tapers smoothly to the ampulla. No extrinsic compressing lesion is identified. No ampullary lesion identified.There is a 20 x 20 mm segment 4 hepatic cyst (series 4, image 28) in addition to multiple, scattered subcentimeter cysts.SPLEEN: The spleen is normal.PANCREAS: The pancreatic duct is mildly prominent and there is a patent accessory pancreatic duct. The pancreas is otherwise normal.ADRENAL GLANDS: The adrenal glands are normal.KIDNEYS, URETERS: There are bilateral renal cysts, otherwise the kidneys are normal and enhance symmetrically.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy noted.BOWEL, MESENTERY: Multiple polypoid lesions are noted in the transverse colon (series 4, images 1 and 3) measuring up to 12 mm without significant enhancement. The remaining small bowel and colon are otherwise unremarkable.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Right pleural soft tissue and loculated fluid collections are again noted similar to CT from 10/28/2015.
1.Intra and extrahepatic biliary duct dilatation to the level of the ampulla without obstructing intraluminal or extrinsic lesion.2.Transverse colonic polypoid lesions which can be evaluated with colonoscopy as clinically warranted.3.Right pleural disease as characterized on prior studies.