68-year-old woman with history of PBC with multiple pancreatic cysts and liver lesions. ABDOMEN:LIVER, BILIARY TRACT: Liver is cirrhotic in morphology with reticular increased T2 signal indicating fibrosis. A TIPS stent is patent.2 focal hepatic lesions are seen on arterial phase imaging with slightly increased T2 signal and diffusion restriction. These lesions are isointense to liver parenchyma on venous and delayed phase images. The first measures 23 x 19 mm, previously 20 x 20 mm in segment 7 (9/80). The second measures 12 x 11 mm, previously 8 x 8 mm in segment 5/6 (9/69).Prominent dilation of the extrahepatic biliary system is unchanged. There is no intrahepatic biliary ductal dilatation.SPLEEN: Borderline splenomegaly.PANCREAS: The pancreatic parenchyma is near completely replaced by cysts and has not changed in appearance significantly from 2008 study.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small simple cysts bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1.Cirrhotic morphology of liver with two arterially enhancing lesions with imaging characteristics suspicious for but not entirely diagnostic of hepatocellular carcinoma. Of note, the segment 5/6 lesion has grown slightly from the prior exam.2.Near complete replacement of the pancreatic parenchyma with cysts representing unchanged main branch and side branch type IPMNs.