Male 63 years old Reason: eval for intrahepatic lesion History: worsening Bili ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. Status post drainage using a metallic common bile duct stent. There is residual mild intrahepatic biliary ductal dilatation. There is soft tissue infiltrating along the portal triads from the porta hepatis into the liver. This causes some mild extrinsic compression upon the portal triads. The common bile duct stent appears patent.There are few scattered lesions within the liver the largest near the dome of the liver measuring 1.7 x 1.5 cm with imaging features compatible with metastases.Hepatic and portal veins are patent.SPLEEN: Scattered splenic lesions may represent subcentimeter metastatic deposits.PANCREAS: No pancreatic ductal dilatation. There is mild interstitial edema involving the pancreas body suggestive of mild pancreatitis. There are few scattered cystic foci in the pancreatic head which may represent small branch type PMNs.ADRENAL GLANDS: Left adrenal gland mass measures 4.5 x 3.5 cm and has imaging features compatible with metastases.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Necrotic adenopathy posterior to the head of the pancreas measures 2.5 x 2.4 cm.Extensive necrotic mesenteric lymphadenopathy.BOWEL, MESENTERY: Status post subtotal colectomy. There is extensive mesenteric necrotic lymphadenopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Status post decompression of the biliary tree with mild residual intrahepatic biliary ductal dilatation without focal stricture.2.Hepatic metastases with infiltrative changes along to the portal triads which may represent infiltrative metastatic disease along the portal triads.3.Necrotic left adrenal, mesenteric and peripancreatic lymphadenopathy.