History of myelofibrosis. ABDOMEN:LIVER, BILIARY TRACT: A few hepatic cysts are noted. No focal suspicious lesion or biliary ductal dilatation.Status post cholecystectomy with postsurgical susceptibility artifact in the gallbladder fossa.Poor visualization of the portal vein with several small caliber collateral vessels in the porta hepatis suspicious for portal vein thrombosis. SPLEEN: Marked splenomegaly with the spleen measuring 29 cm in the craniocaudal dimension. At the level of the celiac artery origin the spleen measures 19 x 12.7 cm in cross-section. No focal splenic lesion. Numerous perisplenic collateral vessels are present the appearance of which is suspicious for splenorenal shunting. The largest varix measures up to 1.6 cm. Minimal perisplenic fluid. Small peripheral irregularly-shaped parenchymal signal abnormality likely reflects a prior small infarct.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Several right renal simple cysts. Subcentimeter right renal hemorrhagic cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Heterogeneous bone marrow signal intensity.OTHER: No significant abnormality noted.
1.Marked splenomegaly with perisplenic collateral vessels and appearance suspicious for splenorenal shunting.2.Poor visualization of the portal vein which appears replaced with several porta hepatis small caliber vessels, suspicious for portal vein thrombosis. Color Doppler ultrasound may be considered to confirm patency as clinically warranted.