65-year-old female with increasing alpha-fetoprotein (AFP 84), cirrhosis, preliver transplant evaluation. Assess for liver lesions. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology. TIPS stent is patent. Nonspecific prominent lymph nodes in the gastrohepatic and periportal distribution. In hepatic segment 4A, there is a 5 x 6.1 cm ill-defined lesion peripheral enhancement and peripheral restricted diffusion (series 10012 images 195, 308) (series 10 image 93). Invasion of the medial segment of the left portal vein is suspected (series 12 image 191).SPLEEN: Splenomegaly measuring 15.2 cm in length.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left lower pole simple cyst. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No peritoneal disease.BONES, SOFT TISSUES: Suspected osseous hemangioma of the T12 vertebral body (coronal series 6 image 28).OTHER: Small right pleural effusion.INDEX LESION MEASUREMENTS (Current exam date/time: 11/11/2016 08:30:00)SEGMENT 4A LESION: 6.1 x 5.0 cm (Image 195, Series 12).
Suspicious peripherally enhancing mass of hepatic segment 4A measuring 5 x 6.1 cm. The differential includes cholangiocarcinoma versus poorly differentiated hepatocellular carcinoma. Findings were discussed with Dr. Aronsohn via telephone on 11/11/2016 at 15:30.