History of cirrhosis. ABDOMEN: is LIVER, BILIARY TRACT: The demonstrated cirrhotic morphology with atrophy of the right lobe, widening of intrahepatic fissures and surface nodularity.Anterior to the right hepatic vein segment VIII is an arterially enhancing focus measuring up to 2.0 x 1.4 cm (series 36/75). The lesion demonstrates washout on the delayed/equilibrium phase (series 39/72) and mild T2-weighted hyperintensity (series 22/29). The lesion demonstrates mild loss of signal on out-of-phase imaging compatible with focal fat. These findings meet the accepted imaging criteria for imaging diagnosis of HCC.No additional suspicious arterial enhancing liver lesion.Portal and hepatic veins are patent without evidence of intraluminal thrombosis.The gallbladder is full of gallstones with non-specific mild wall thickening and mild pericholecystic fluid. No intra or extrahepatic biliary ductal dilatation.Recannulated umbilical vein and other portosystemic collaterals indicative of portal hypertension.. SPLEEN: Moderate splenomegaly measuring 18.7 cm in craniocaudal dimension. Perisplenic collaterals. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 5.7 cm exophytic cyst of the inferior pole of the left kidney. Right renal cysts. No hydronephrosis. Small splenorenal shunt. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Small amount of ascites seen about the inferior right liver.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Cirrhosis with splenomegaly indicating portal hypertension, with small amount of ascites. 2. Approximately 2.0 cm arterial enhancing lesion in segment VIII with washout and T2 hyperintensity meeting imaging criteria for HCC.3. Cholelithiasis with gallbladder wall thickening -- in the absence of symptomatology suggesting acute gallbladder disease, gallbladder wall thickening is common in patients with cirrhosis and not indicative of acute disease.