Outside imaging concerning for hepatocellular carcinoma. History of alcoholic cirrhosis. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology with micronodular contour and reticular T2-weighted fibrotic changes. Moderate perihepatic ascites.In segment 7 of the liver there is a 3.6 x 2.9 cm (series 13/59) intrinsically T1 hyperintense lesion demonstrating postcontrast enhancement which is less than the background liver and no definite washout.Additional 1.3 cm lesion in the right hepatic dome (series 13/73) demonstrates similar imaging characteristics. Additional T2-weighted hypointense subcentimeter nodules are noted in the liver.No intra or extrahepatic biliary ductal dilatation.Partially distended gallbladder with numerous gallstones. Nonspecific minimal pericholecystic fluid.The vessels appear patent.SPLEEN: Splenomegaly measuring 16.5 cm in the craniocaudal dimension with numerous siderotic micronodules.PANCREAS: 1.6 x 1.6 pancreatic body cystic lesion demonstrates no postcontrast enhancement but has mild internal complexity. No definite communication with the main pancreatic duct which is normal in caliber. Normal variant ductal anatomy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The stomach is significantly distended to the level of the second portion of the duodenum without a discrete mass lesion evident, of unclear etiology. Small volume ascites.BONES, SOFT TISSUES: Recannulated periumbilical vein. Bilateral gynecomastia.OTHER: No significant abnormality noted.
1. Cirrhotic liver with extensive fibrosis and nodularity. 2. 3.6 cm segment VII lesion does not meet imaging criteria for hepatocellular carcinoma at this time and may represent a giant regenerative nodule or dysplastic nodule. Additional 1.3 cm right hepatic dome lesion with similar imaging characteristics. Continued surveillance imaging is recommended.3. Small volume ascites, splenomegaly and collateral vessel formation compatible with portal hypertension.4. 1.6 cm pancreatic body cystic neoplasm with mild internal complexity but no postcontrast enhancement. Follow up is suggested.