Male 67 years old Reason: cholangiocarcinoma History: cholangiocarcinoma ABDOMEN:LIVER, BILIARY TRACT: Progressive atrophy of the left lateral segment of the liver and segment 4. This is due to an infiltrative mass which two large portions. The segment 2/3 portion of the mass measures at least 6.6 x 5.5 cm (image 75 /series 17). The lesion appears to extend past the capsule with extension across the gastrohepatic ligament to the stomach.The segment 4 portion of the mass at the hepatic dome measures at least 4.3 x 3.3 cm (image 84/series 17). It invades the diaphragm with tumor bulging the diaphragm.Additional probable lesion near segment 4/5 of the liver.Left portal vein is thrombosed. The left hepatic vein is thrombosed. The middle hepatic vein is narrowed.There is diffuse T2 signal abnormality involving the right hepatic lobe without a correlate on the postcontrast imaging.Subcentimeter scattered lesions in the right hepatic lobe are too small to characterize.There is no biliary ductal dilatation. The common bile duct is normal in caliber. Left hepatic ducts are obliterated by the tumor.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst. Probable cyst at the lower pole of the right kidney.RETROPERITONEUM, LYMPH NODES: Are small retroperitoneal lymph nodes. An aortocaval lymph node measures 1.7 x 1.2 cm (image 255/series 15). BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of upper bowel ascites adjacent to the left lobe of the liver.
1.Findings of a large predominantly left hepatic lobe mass with likely extension across the gastrohepatic ligament to the stomach.2.Thrombosis of the left portal vein, left hepatic vein and severe narrowing of the middle hepatic vein.3.Upper abdominal ascites near the gastrohepatic ligament suspicious for peritoneal disease.