Male 59 years old Reason: HCC screening, vascular patency History: s/p OLT, being evaluated for repeat OLT ABDOMEN:LIVER, BILIARY TRACT: The liver demonstrates a nodular contour and prominence of the hepatic fissures consistent with cirrhosis. There is no focal liver lesion.The arterial phase of imaging is limited. While the main hepatic artery appears grossly patent, they are suboptimally evaluated and could be definitively characterized with dedicated Doppler ultrasound. The portal veins and hepatic veins are patent.SPLEEN: Splenomegaly measuring 15.4 cm. T2 hyperintensity within the spleen likely represents a small cyst.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: Multiple enlarged portacaval, retroperitoneal and mesenteric lymph nodes. While regional lymphadenopathy is expected in the setting of cirrhosis, the location of some of these is somewhat atypical. Additionally, some of the nodes demonstrate a subtle increase in size compared to prior study 01/02/14. While these may be reactive, low-grade lymphoma is a differential consideration. Continued attention should be paid to these on follow-up imaging. A reference left retroperitoneal lymph node measures 2.0 x 1.6 cm (series 9, image 64), previously 1.7 x 1.4 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1.Cirrhotic liver morphology with portal hypertension. No focal liver lesion.2.Limited arterial phase imaging makes evaluation of the main hepatic artery difficult. While this appears grossly patent this could be definitively characterized with Doppler ultrasound. The portal veins and hepatic veins are patent.3.Multiple enlarged abdominal lymph nodes. While regional lymphadenopathy is expected in the setting of cirrhosis, the location of some of these is somewhat atypical. Low-grade lymphoma is a differential consideration and continued attention should be paid to these on follow-up imaging.