76 year old female with history of metastatic lung cancer. Elevation of LFTs. Evaluate for obstruction. LIVER: The liver is minimally coarsened. No discrete mass lesion is identified; this may be better characterized with CT/MRI as clinically warranted, given the presence of metastatic lesions on the CT from 05/16/2014. The liver measures 16.1 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation is identified. Normal hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: The common bile duct is dilated up to 10 mm and tapers smoothly to the hepatic hilum. A normally distended gallbladder is present. There is focal fundal hyperechoic thickening with associated ring-down artifact, likely representing focal adenomatosis. No gallstones, focal tenderness or pericholecystic fluid.PANCREAS: The visualized portions of the pancreatic body and head appear grossly normal.SPLEEN: The visualized portions of the spleen are unremarkable. It measures 7.6 cm in length.RIGHT KIDNEY: The right kidney measures 12.7 cm in length without hydronephrosis or shadowing calculus. 3.0-cm simple the inferior pole cyst. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 11 cm in length without hydronephrosis or shadowing calculus. 1.5-cm simple appearing interpolar cyst, better characterized on prior CT.
1. Common bile duct dilatation up to 10 mm is decreased compared to the prior CT from 12/5/2014. No intrahepatic biliary ductal dilatation is evident.2. No discrete liver mass lesion is identified; this may be better characterized with CT/MRI as clinically warranted, given the presence of metastatic lesions on the CT from 05/16/2014. 3. Focal gallbladder fundal adenomyomatosis, of no clinical significance.