History of hepatitis C. Multiple liver lesions previously characterized as multifocal hepatocellular carcinoma on imaging. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic nodular liver morphology.Since the prior study there has been significant increase in size of the previously measured liver mass and multiple new and enlarging liver masses infiltrating the right hepatic lobe. The reference lateral segment confluent mass measures approximately 17.9 x 8.9 cm compared to 14.3 x 6.4 cm previously.The portal vein is poorly demonstrated. Gallstones within a normally distended gallbladder.SPLEEN: The spleen measures 11.2 cm in length without a focal lesion.PANCREAS: Pancreas divisum. No pancreatic ductal dilatation or focal lesion. No stigmata of chronic pancreatitis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal simple appearing cyst. Punctate hyperintensities bilaterally are too small to characterize, likely cysts. No hydroureteronephrosis or suspicious lesion.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large volume abdominal pelvic ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild basilar atelectasis.
Interval increase in the large lateral segment reference mass and increase in size and number of numerous additional liver masses compatible with progression of multifocal hepatocellular carcinoma.The portal vein is poorly demonstrated. If there is clinical concern for occlusion an ultrasound may be considered.Cholelithiasis without cholecystitis.