Female 40 years old; Reason: left lobe mass 12 cm on CT scan, compatible with giant hemangioma. Several other mass lesions. Need to confirm these are hemangiomas. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Prominent liver (measures up to 20 cm in craniocaudal dimension, likely due in part to Reidel lobe) and left lobe extends peripherally into left upper quadrant. Dominant left lobe mass measures 12.1 x 7.9 cm, demonstrates peripheral puddling in arterial phase with subsequent centripetal progression of enhancement, appearance consistent with a giant hemangioma. Multiple additional smaller lesions with similar enhancement characteristics seen in both lobes, again consistent with hemangiomas. There is also a hepatic segment 6 lesion measuring 3.1 x 3 cm, image 67 series 1101, which demonstrates fairly homogeneous arterial enhancement with near isointensity demonstrated on subsequent portal venous phase and lesion is essentially isointense on delayed imaging. Constellation of findings consistent with an FNH (focal nodular hyperplasia). Lesion is mildly T2 hypointense and minimally T1 hypo- to isointense. SPLEEN: 0.8 cm lesion in the spleen, image 59 series 1101, appearance suggestive of a small hemangioma.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: No significant abnormality noted.BONES, SOFT TISSUES: Ill-defined focal heterogeneous enhancement (measures 1.7 x 1.4 cm) seen at level of right lower rib cage, near or at inferiormost costochondral junction, image 76 series 1101.
1. Left-sided giant hepatic hemangioma with additional smaller bilobar hemangiomata present. 2. Hepatic segment 6 lesion with imaging characteristics consistent with an FNH.3. Ill-defined focal heterogeneous enhancement seen at level of right lower rib cage, near or at inferiormost costochondral junction, may reflect subacute rib fracture with surrounding callus formation but correlation with patient's clinical history and physical examination for point tenderness recommended and further assessment with CT imaging is recommended if there is clinical concern for underlying lesion.