75-year-old female with jaundice ABDOMEN:LIVER, BILIARY TRACT: Innumerable lesions scattered throughout the liver highly suspicious for metastatic disease.Marked intrahepatic biliary ductal dilatation leading up to the Klatskin point. A mass at the Klatskin point extends into the common bile duct as well as infiltrates into the liver parenchyma. The common bile duct does not opacify.Enlarged periportal lymph node measuring 12 mm (series 11, image 341).The hepatic vasculature are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Nonenhancing fluid intensity left adrenal lesion may represent a cyst.KIDNEYS, URETERS: Left interpolar and inferior pole renal cyst. Additional subcentimeter T2 hyperintense lesions are likely cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderate hiatal hernia. Colonic diverticulosis without evidence of diverticulitis. No peritoneal carcinomatosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Mass invading the Klatskin point and common bile duct with intrahepatic extension and extension into the common bile duct. Innumerable lesions scattered throughout the liver are highly suspicious for metastatic disease. Findings are most concerning for cholangiocarcinoma.Findings discussed with Dr. Choi at 1704 on 7/14/16. 