45 years, Male, Reason: hepatocellular carcinoma History: history of hepatitis C, multiple liver lesions seen on abdominal US. ABDOMEN:LUNG BASES: Right upper lobe airspace opacity was not seen on the prior CT and may represent progression of air space disease.LIVER, BILIARY TRACT: Small amount sludge within the gallbladder. Hepatomegaly. Mild perihepatic ascites. Mildly cirrhotic contour.Enhancing heterogeneous lesion expanding the left hepatic lobe, primarily in segments 2 and 3, but also involving segment 4 demonstrates washout, compatible with hepatocellular carcinoma. There is also a foci of fat present within the lesion. The left portal vein enters the left hepatic lobe mass and is not well seen, likely thrombosed. The left hepatic vein is also not well seen and may be occluded. The remaining portal system is normal.There are additional lesions in the right hepatic lobe which demonstrates enhancement and washout also compatible with hepatocellular carcinoma. For example, right segment 7 lesions measure 1.5 x 1.6 cm (1201/257) and 1.9 x 1.7 cm (1201/269). There are a few smaller enhancing lesions with mild washout (1202/248 and 292). SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple left-sided simple cysts. Additional T2 hyperintense lesions are too small to characterize.RETROPERITONEUM, LYMPH NODES: Mildly enlarged periportal node measures 1.1 x 1.1 cm (1001/26). Mildly enlarged left para-aortic node measures 1.4 x 1.07 m (1001/25).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Gynecomastia.
1.Findings compatible with multifocal hepatocellular carcinoma.2.Mild retroperitoneal lymphadenopathy.3.Right upper lobe air space opacities are new from prior CT.