57-year-old female with history of HCV and HCC. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. Increased T2 reticulation within the liver parenchyma compatible with fibrosis. Large volume ascites.In segment 7 there is a heterogeneous mass with a low signal intensity capsule as well as internal foci of high T1/T2 measuring 5.5 x 4.6 cm (image 34 of series 41). There is no arterial enhancement, however there is diffuse washout extending outside of the boundaries of the capsule likely representing diffusely infiltrative disease.In segment 6, there is a round T2 hypointense lesion with arterial enhancement and washout measuring 2.3 x 2.6 cm (image 24 of series 401).In the lateral segment of the left hepatic lobe there is an ill defined area of signal abnormality with washout.There is a large thrombus within the right portal vein extending into the main portal vein. This thrombus demonstrates foci of enhancement compatible tumor thrombus.Hydropic gallbladder wall thickening likely secondary to hypoproteinemia.Numerous enlarged portal lymph nodes.SPLEEN: Splenomegaly measuring 18 cm.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: Gastric and esophageal varices.
1.Diffuse multifocal HCC as above with tumor thrombus in the right portal vein extending into the distal main portal vein.2.Portal hypertension with gastric and esophageal varices. Splenomegaly.3.Hydropic gallbladder wall thickening likely secondary to hypoproteinemia.