Archive for January, 2009

Findings:

Evaluation limited by motion artifact / technical factors. There is a markedly heterogeneous mass in the liver which measures about 9.5 X 7.3 CM in the anterior segment of the right lobe, which may represent an unusual primary neoplasm or a metastatic focus. No arterial phase images are available. Mild prominence of the central intrahepatic bilary tree however the common duct is nodilated measuring about 4 MM. There are numerous peritoneal implants, most prominent in the right abdomen, strongly suspicious for peritoneal carcinomatosis. There is a prediaphragmatic adenopathy as well as several right pulmonary lesions at the lung base. The extent of disease would be better assessed with CT of chest abdomen pelvis, possibly already performed. Upper abdominal / porta hepatis adenopathy measures at least 1.8 CM in short axis although not optimally evaluated on this study. Small ascites, presumably malignant. The spleen kidneys and pancreas are grossly unremarkable. Adrenals are in large part obscured.

Impression:

Limited study. Extensive metastatic disease suspected in the lower chest and abdomen, including pulmonary lesions, adenopathy, presumed peritoneal carcinomatosis and malignant ascites. Massive hepatic lesion may represent an unusual primary neoplasm or another metastatic focus. Please correlate with the presumed outside CT for evaluation of the entire chest abdomen and pelvis. Pathologic correlation suggested.