PSC. Evaluate for CCA and HCC. ABDOMEN:LIVER, BILIARY TRACT: Diffuse intrahepatic biliary ductal dilatation and irregularity with multifocal strictures, severe in the left hepatic lobe, consistent with PSC, not significantly changed. Increase in central intraductal debris and stones. Mild diffuse irregularity of the common duct with a focal mild stricture at Klatskin's point, unchanged. New 4 mm CBD stone (series 4, image 47). Unchanged mildly T2 hyperintense ill-defined focus with delayed enhancement and subtle capsular retraction in the lateral aspect of the right lobe, segment VI, consistent with confluent fibrosis.No new dominant enhancing stricture or suspicious hepatic mass. Cirrhotic liver morphology.Cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged right renal cyst.RETROPERITONEUM, LYMPH NODES: Stable portocaval and periportal lymphadenopathy, BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small cystic foci at the neural foramina bilaterally at multiple thoracolumbar levels consistent with perineural cysts. Well-defined round cystic foci at the sacral foramina, likely Tarlov cysts.OTHER: No significant abnormality noted.
No suspicious hepatic mass or new dominant enhancing stricture. Stable beaded dilatation of the biliary tree with increase in hepatolithiasis centrally as well as a new 4 mm common duct stone.