History of hepatitis C and cirrhosis. Evaluate for HCC. LIVER: Course liver with nodular contour compatible with history of cirrhosis. The liver measures 14 cm in length. There is a hypoechoic 4.1 x 2.7 x 2.6 vascular hypoechoic mass bulging the hepatic contour.No intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 19 cm/s.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 4 mm. Status post cholecystectomy.PANCREAS: The visualized pancreatic body and head is unremarkable. SPLEEN: The spleen measures 8.2 cm in length without a focal abnormality.RIGHT KIDNEY: The right kidney measures 10.4 cm in length without hydronephrosis. Note is made of a 1.1 cm simple appearing cyst. No shadowing nephrolithiasis. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 10.3 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion.
Cirrhosis with a 4.1 cm vascular hypoechoic right hepatic lobe mass bulging the contour, suspicious for hepatocellular carcinoma. Further characterization with a dedicated liver protocol CT or MRI is recommended.Discussed with ordering clinic (Maria, to be relayed to Dr. Glick) at 1103 on 04/26/2016.