50-year-old male with alcoholic cirrhosis and HCV. Evaluate for hepatic lesions/HCC. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. Segment 6 lesion with vague T2 hyperintensity, arterial enhancement, questionable washout, and pseudocapsule highly concerning for hepatocellular carcinoma; this lesion measures 1.8 x 1.5 cm (series 11, image 70), previously measuring 1.9 x 1.5 cm. The portal vein is patent.There are additional multiple punctate arterially enhancing foci without definite washout (for example series 11, images 31, 53, and 62). Cholelithiasis.SPLEEN: Splenomegaly. Splenule is noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Cirrhotic liver morphology with segment 7 lesion as detailed above highly concerning for hepatocellular carcinoma based on UNOS/OPTN criteria, but not necessarily by AASLD.2.Multiple additional punctate arterially enhancing nonspecific hepatic foci without evidence of washout likely perfusional anomalies, but attention on subsequent follow up imaging suggested.