Female 33 years old Reason: evaluate liver lesions in pt with pancreatic neuroendocrine tumor s/p resection of pancreatic primary with new liver lesions on CT History: abdominal fullness ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. There are 6 hepatic lesions. The largest in the right lobe of the liver in segment 8 measures 6.3 x 5.8 cm with a central scar, has arterial enhancement without washout and is compatible with focal nodular hyperplasia.The 5 other lesions located in segments two (2 lesions) , segment 3, segment 6 and segment 8 also show arterial enhancement and no washout.The segment 3 lesion is T2 hyperintense unlike the rest of the lesions and is favored to be a flash filling hemangioma. The segment 6 lesion is T2 hyperintense and has progressive filling is also favored to be a hemangioma.The remaining three lesions in segment 2 and segment 8 have imaging features suggesting focal nodular hyperplasia but are not diagnostic for the entity given their small size. There are less likely to represent metastatic disease as it have no washout.There is minimal central biliary ductal dilatation with mild focal areas of narrowing in the central left and right hepatic bile ducts. There is thrombosis of the portal vein with cavernous transformation.SPLEEN: Spleen is enlarged. Splenic venous thrombosis.PANCREAS: The postsurgical changes in the head of the pancreas. No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: There are several lymph nodes adjacent to the surgical bed.BOWEL, MESENTERY: Postsurgical changes in the bowel. Soft tissue surrounding the superior mesenteric artery is unchanged.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No ascites.PELVIS:UTERUS, ADNEXA: Bilateral adnexal cysts. Endometrial thickness is normal.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No ascites.
1.Multiple hepatic lesions with the largest lesion having imaging features of focal nodular hyperplasia.2.Two lesions have imaging features of hemangiomas.3.Remainder of the lesions have imaging findings suggestive of focal nodular hyperplasia but are not definite for the entity due to their small size.4.Postsurgical changes in the pancreas with adjacent lymph nodes.5.Thrombosis of the portal vein with cavernous transformation.6.Mild central biliary duct irregularity of unclear etiology.7.Splenic vein thrombosis with enlarged spleen.