Female; 54 years old. Reason: Evaluate for cholangiocarcinoma History: PSC, elevated CA 19-9 and prior concern for Klatskin point lesion. LIVER, BILIARY TRACT: Multifocal areas of dilatation and stricturing are again noted in the intra and extrahepatic bile ducts, compatible with the patient's known primary sclerosing cholangitis with stable overall configuration. Stricture of the proximal common hepatic duct includes Klatskin's point and measures 1.5 cm in length, unchanged (series 3, image 63). Mild stricturing of the distal common bile duct is also similar to prior MRI and measures 3.1 cm in length (series 3, image 64). No definite intraductal lesions are noted. Stable small right liver cyst. No suspicious hepatic lesions. SPLEEN: No significant abnormality noted.PANCREAS: Scattered subcentimeter cystic lesions adjacent to the pancreatic duct may represent sidebranch IPMNs (intraductal papillary mucinous neoplasm, series 3 image 56). ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral simple renal cysts. 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.
Overall stable appearance of primary sclerosing cholangitis as described above. No new intraductal masses or suspicious liver lesions. 