56 years, Male, Reason: Concern for CCA/stricturing that needs intervention History: PSC. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT:Mild contour abnormality of the liver and heterogeneous all T2 intensity is compatible with fibrosis.Multifocal bilobar biliary strictures as are again seen, left greater than right, with focal stricturing and irregularity of the proximal common bile duct and cystic duct appearing similar to the prior exam. No focal masses evident. Multiple filling defects within the intrahepatic bile ducts likely represent stones. No new stricturing of the common bile duct.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic duct is normal in caliber. A cystic lesion within the tail of the pancreas measuring 8 mm (601/43) appears to connect with the main pancreatic duct and likely represents a sidebranch IPMN.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Peri-portal lymphadenopathy is unchanged with a reference node measuring 2.2 x 1.4 cm (401/17).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Multifocal intrahepatic and extrahepatic biliary stricturing appears similar to the prior exam and is suggestive of primary sclerosing cholangitis.2.Sidebranch IPMN in the pancreatic tail.3.Stable periportal lymphadenopathy.