24-year-old female with primary sclerosing cholangitis, evaluate for cholangiocarcinoma. ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis.Intrahepatic biliary ductal dilatation has increased from the prior exam. There areas of intrahepatic beading and narrowing, which have progressed since prior exam. No dominant stricture is evident. The common bile duct measures 9 mm to the level of the ampulla, previously 7 mm.No suspicious hepatic lesions. Mildly prominent portacaval lymph nodes.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: No significant abnormality noted.BOWEL, MESENTERY: A thick walled pouch is present within the pelvis.BONES, SOFT TISSUES: Mild rightward curvature of the spine.OTHER: Small amount of free fluid in the pelvis and small follicles are likely physiologic.
1.Intrahepatic biliary ductal dilatation and intrahepatic strictures likely related to primary sclerosing cholangitis have increased since the prior exam.2.Increased dilatation of the common bile duct to the level of the ampulla, which is likely stenosed.3.No suspicious hepatic lesions to suggest cholangiocarcinoma.