History of cirrhosis and hepatocellular carcinoma status post TACE RFA. Interval follow-up exam. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology liver with surface nodularity and fissural widening. There is diffuse reticular increased T2 signal compatible with fibrosis. Unchanged ablation defect in segment 6/7.There is a focus of arterial enhancement in segment 6 which measures 1.3 x 0.9 cm. There is no definite washout, restricted diffusion, or associated T2 signal abnormality, however this lesion remains suspicious as it has approximately doubled in size compared to the prior exam.No focal lesions meeting diagnostic criteria for hepatocellular carcinoma.The hepatic artery, hepatic veins, and portal veins are patent. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: Borderline splenomegaly with the spleen measuring 13 cm in length.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: No significant abnormality noted.OTHER: Large gastroesophageal varices.
1.Segment 6 arterial enhancing 1.3 cm lesion as described above. While not meeting definitive criteria for hepatocellular carcinoma, this lesion remains suspicious as it has doubled in size since the prior exam. Short interval follow-up is recommended.2.Hepatic cirrhosis with borderline splenomegaly and prominent gastroesophageal varices formation.