History of non-small cell lung cancer with enlarging right hepatic lobe lesion. ABDOMEN:LIVER, BILIARY TRACT: Right hepatic centrally located necrotic mass measuring approximately 4.9 x 4.1 cm, image 36 series 10. Peripheral lesional enhancement seen. Neoplastic focus seen inferomedially in hepatic segment 5/6 region on image 51 series 11 represents component of aforementioned mass (favored) versus adjacent separate lesion. Associated restricted diffusion seen and occlusion of right hepatic vein and right portal vein, primarily the posterior segment, visualized. Mild mass effect on adjacent IVC laterally. Additional arterially enhancing small 5 mm hepatic segment 6 focus seen on image 61 series 10, no definite corresponding washout seen in subsequent delayed imaging, persistent contrast retention seen (see image 67 series 11 and image 64 series 12), suggesting a tiny hemangioma; additionally, no corresponding restricted diffusion seen and no associated hypermetabolic activity visualized on prior PET/CT imaging. Other punctate T2 hyperintense foci most likely cysts. No biliary duct dilatation. Mildly prominent but nonpathologically enlarged portacaval, periportal lymph and aortocaval nodes. Submitted for reference is 1.5 x 0.9 cm portacaval lymph node, image 53 series 10. SPLEEN: Subcentimeter splenule, image 50 series 9.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Right hepatic centrally located necrotic mass, appearance favoring that of a metastatic lesion.2. Mildly prominent portacaval, periportal lymph and aortocaval nodes, nonspecific.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.