History of Li Fraumeni Syndrome with liver lesions on PET. History of breast cancer. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology and size. There is loss of signal on the out of phase images consistent with fatty infiltration.There are several hepatic lesions. The largest in segment 6/7 measures 2.7 x 2.3 cm (series 11/20) and the inferior right hepatic lobe measuring 1.8 x 1.6 cm (series 11 image 32) with similar imaging characteristics, specifically homogeneous macroscopic fat content without enhancing components compatible with lipomas or angiomyolipomas.There are several additional arterial homogeneously enhancing foci most of which are subcentimeter. The largest in the inferior right hepatic lobe measures 1.5 x 1.6 cm (series 13/72), which is mildly hyperintense on T2-weighted sequences. This larger lesion demonstrates mild restricted diffusion. There is no washout on portal venous or delayed imaging, restricted diffusion of the remaining lesions, rim enhancement or other suspicious imaging characteristics.There is a right hepatic lobe segment 7 peripheral/subcapsular wedge-shaped region of post-contrast enhancement, compatible with a THID (Transient Hepatic Intensity Difference).No vascular abnormality. Status post cholecystectomy.SPLEEN: Normal splenic morphology and size without a focal lesion.PANCREAS: Normal pancreatic morphology and signal intensity without a discrete lesion. The pancreatic duct is normal in caliber.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: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted. Left ovarian physiologic cysts.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Several arterial homogeneously enhancing foci most of which are subcentimeter, including an indeterminant 1.6 cm right inferior hepatic lobe lesion demonstrating mild T2-weighted hyperintensity, enhancement and restricted diffusion. The remaining lesions demonstrates no apparent washout, restricted diffusion, rim enhancement or other suspicious imaging characteristics. We recommend that the patient returns for a 45 minute to 2 hour delayed imaging sequence following hepatobiliary agent administration to evaluate whether this lesion is an FNH or possible metastatic lesion. The patient will be called back by the radiology department at no cost to the patient for this additional imaging.2. 2.7 and 1.8 cm hepatic lipomas. 3. Steatosis.