66-year-old male with history of HCC in a transplanted liver. Please restage. ABDOMEN:Study is limited by extensive susceptibility artifact from the patient's surgical hardware.LIVER, BILIARY TRACT: Orthotopic liver transplant. A large portion of the liver cannot be evaluated due to extensive susceptibility artifact from the patient's IVC stent.Stable segment 5 reference lesion measuring 0.9 x 0.9 cm, and washout is again noted. Other small T1 hyperintense foci are similar in size and number.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable small cyst of the left lower renal pole. No acute abnormality.RETROPERITONEUM, LYMPH NODES: Similar-appearing heterogenous lesions in the periaortic distribution measuring approximately 10.1 x 11.7 cm on the right and 9.4 x 10.2 cm on the left.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable ventral midline incisional fat-containing hernias.OTHER: Right pleural effusion, and a 1.4 x 1.2 cm right posterior pleural-based lesion is unchanged.
1.Stable large heterogenous masses of periaortic lymphadenopathy.2.Multiple liver lesions not significantly changed in size or number. These lesions are again suspicious for multiple dysplastic nodules and/or multifocal HCC. Reference lesion in hepatic segment 5 is stable in size. The exam is markedly limited due to extensive susceptibility artifact from the patient's IVC stent. Consider CT evaluation of follow-up exams for more optimal visualization of hepatic parenchyma, portal veins, and/or hepatic veins.3.Stable right pleural effusion and approximately 1.4 x 1.2 cm right pleural-based nodule.