25-year-old female with multiple liver lesions, deemed to be FNH. Please do FNH protocol. Previous Ewing's sarcoma. ABDOMEN:LIVER, BILIARY TRACT: The liver measures 20 cm in craniocaudal dimension. There is diffuse loss of signal on out of phase imaging indicating hepatic steatosis.Multiple T2 hyperintense lesions are again seen throughout the liver parenchyma. In the posterior right hepatic dome a T2 hyperintense, arterially enhancing lesion measures 3.2 x 1.8 cm (series 1403, image 292), previously 1.9 x 1.2 cm. This lesion does not retain contrast on the delayed hepatobiliary phase images.Numerous additional T2 hyperintense, arterially enhancing hepatic lesions retain contrast on hepatobiliary phase imaging compatible with focal nodular hyperplasia and appear similar in size and appearance when compared to the previous exam.A nonenhancing lesion anteriorly in the left lobe the liver measures 1.3 x 1.0 6 cm, it is T2 hyperintense and T1 hypointense compatible with a simple cyst.No intra or extrahepatic biliary ductal dilatation. No cholelithiasis. The hepatic vasculature appears patent.SPLEEN: The spleen measures 9.8 cm in craniocaudal dimension.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: Right lower lobe peribronchial vascular soft tissue thickening was better evaluated on prior chest CTs.
1.Hepatic steatosis. 2.Interval increase in size of posterior right hepatic dome lesion. Given the lack of persistent enhancement this is favored to represent an adenoma, particularly the inflammatory subtype (given avid enhancement particularly in arterial phase and background of diffuse hepatic steatosis), although an atypical FNH is not entirely excluded.3.Additional lesions throughout the liver parenchyma are stable and have imaging features compatible with FNH.