57-year-old female with hyperbilirubinemia, right upper quadrant pain, myeloproliferative infiltrate into the liver. Evaluate for biliary obstruction. ABDOMEN:LIVER, BILIARY TRACT: The liver measures approximately 22 cm and demonstrates capsular nodularity consistent with cirrhosis. The liver is heterogeneous in echotexture.No intra or extrahepatic biliary ductal dilatation. At the level of the confluence of the right and left biliary duct, there is nonopacification of the common bile duct measuring approximately 5 mm and caudal dimension (series 9, image 102). Mild stricture is not excluded; however, there is no upstream biliary dilatation.SPLEEN: The spleen is heterogeneous in appearance with multiple heterogeneous lesions with the largest measuring 2.2 x 4.3 cm (series 6, image 20).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: Small volume ascites is present.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Cirrhosis and hepatosplenomegaly.2.Heterogeneous hepatic parenchyma, most likely related to the myeloproliferative process.3.Multiple splenic lesions likely related to myeloproliferative process.4.Non-opacification at the biliary confluence apparent only on MRCP images nonspecific but likely related to technique given that there is no significant upstream dilatation; however, very mild stricture is not entirely excluded.