New hepatic lesion. History of cirrhosis and alcohol abuse. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. The liver measures 16.7 cm in the craniocaudal dimension.There is a 4.0 x 4.0 cm right hepatic dome segment 8 lesion which bulges the liver contour and is heterogeneously T2 hyperintense in signal intensity with small cystic components. The lesion demonstrates restricted diffusion. On postcontrast images the lesion demonstrates peripheral contiguous thick walled mildly nodular enhancement with multiple internal enhancing septations. (Series 1002/36). There is no progressive enhancement of the lesion. In segment 5 of the liver there is a lobular arterial enhancing lesion measuring 2.5 x 1.8 cm (series 1002/62) demonstrating wash-out and suggestion of capsule formation on the delayed/equilibrium phase images (series 1004/62). The lesion contains intracellular fat and demonstrates restricted diffusion. No intrahepatic or extrahepatic biliary ductal dilatation. Normal distended gallbladder with pericholecystic fluid/gallbladder wall thickening, nonspecific in the setting of ascites. Cholelithiasis.The main portal vein is patent.SPLEEN: The spleen measures 12.1 cm in the craniocaudal dimension. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Left periaortic collateral vessel formation suggestive of portal hypertension.BOWEL, MESENTERY: Trace perihepatic and right paracolic gutter and pelvic ascites.BONES, SOFT TISSUES: Severe compression fracture of L1. Bilateral gynecomastia. Small fat-containing umbilical hernia with trace fluid.OTHER: See recent CT chest report for pulmonary findings.
1.2.5 cm segment 5 lesion with enhancement and wash-out meeting imaging criteria for HCC.2.Indeterminate 4.0 cm lesion in the right hepatic dome, segment VIII demonstrating peripheral nodular thick-walled enhancement and numerous internal enhancing septations. Differential considerations include a hematoma or infection (in the appropriate clinical context). Otherwise, a primary hepatic neoplasm, such an atypical HCC or cholangiocarcinoma should be considered. 3. Cholelithiasis. Pericholecystic fluid and gallbladder wall thickening is nonspecific in the setting of ascites. No biliary ductal dilatation.4. Severe compression fracture of L1, unchanged dating back to 2013.