58-year-old female with history of gallbladder carcinoma. Evaluate for obstruction. ABDOMEN:LIVER, BILIARY TRACT: The gallbladder is distended with soft tissue consistent with tumor and calcified stones. There is additionally a calcified stone in the neck of the gallbladder. There is trace pericholecystic fluid.There are innumerable hepatic heterogeneous peripherally T2 hyperintense, diffusion restricting, hypovascular lesions replacing nearly the entire hepatic parenchyma; findings compatible with extensive metastatic disease.The proximal to mid common bile duct is compressed extrinsically from metastatic disease (series 901, image 72). There is mild right and left intrahepatic biliary prominence.Although, the portal venous system is patent, there is mild to moderate attenuation of the left and right portal veins by the metastatic disease.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: There is mildly enhancing, extensive retroperitoneal lymphadenopathy with index lymph node measuring 4.0 x 3.0 cm (series 1301, image 30).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small bilateral pleural effusions.
1.Mass and calcified cholelithiasis within the gallbladder fossa compatible with patient's history of gallbladder carcinoma. Calcified stone in the gallbladder neck.2.Extensive diffuse hepatic metastatic disease replacing nearly the entire normal hepatic parenchyma. Mild to moderate portal venous attenuation from metastatic disease.3.Proximal to mid common bile duct is compressed extrinsically from metastatic disease resulting in mild intrahepatic biliary prominence.4.Extensive retroperitoneal lymphadenopathy.