28-year-old female with history of pancreatic cancer on chemotherapy and new hepatic lesion presents for further evaluation of the hepatic lesion. Patient with history of liver transplant for biliary atresia at age 10 months. ABDOMEN:LIVER, BILIARY TRACT: Segments 5 lesions with central T2 hyperintensity and peripheral enhancement; the reference lesion measures 1.6 x 1.1 cm (series 9, image 59), previously measuring 1.5 x 1.2 cm. Near the hepatic dome, there is ill-defined linear T2 hyperintensity, nonspecific. Additionally, there are 2 nonspecific subcentimeter T2 and T1 hypointense nonenhancing foci in right hepatic lobe (series 9, images 40 and 44). Artifact from stent within the main portal vein limits evaluation of the main portal vein.Additionally, there is focal intrahepatic biliary ductal dilatation (compared to the MRCP July 2015 examination).SPLEEN: No significant abnormality noted.PANCREAS: Heterogeneous T2 hyperintense mass in the pancreatic head with extension to the caudate lobe. This lesion measures 5.6 x 4.3 cm (series 3, image 17), not significantly changed. There is dilatation of the pancreatic duct distally which measures up to 6 mm. The distal body and pancreatic tail are atrophic.The inferior T2 hyperintense focus is also stable in size measuring 5.0 x 3.1 cm (series 3, image 28).The pancreatic mass encases the celiac and hepatic arteries. The inferior cystic mesenteric lesion abuts the superior mesenteric artery. Again noted is attenuation of the splenic vein near the confluence.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retroperitoneal, pancreatic, gastrohepatic, and porta hepatis lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Stable pancreatic head mass and mesenteric cystic metastatic focus.2.Segment 5 rim-enhancing foci as detailed. Abscesses are favored over metastatic disease.3.Nonspecific subcentimeter T1 and T2 hypointense, nonenhancing right hepatic lobe foci as above.4.Focal intrahepatic biliary ductal dilatation may represent adjacent strictures.