66-year-old female patient with elevated liver enzymes on immunosuppresion medication for lung transplant. LIVER: The liver measures 16.4 cm in length. Hepatic parenchymal echogenicity is increased and there is nodularity of the liver contour. Scattered hepatic cysts are noted, the largest within the right hepatic lobe measuring approximately 1.1 cm in the largest dimension. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There is a subcentimeter gallbladder polyp near the fundus. No gallstones are identified. Gallbladder wall thickening is non-specific in the setting of ascites. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 5 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 6.7 cm in length. No evidence of hydronephrosis. The kidney is atrophic with increased cortical echogenicity. A 1.6 cm right lower pole simple cyst is noted.OTHER: The left kidney measures 6.4 cm in length. No evidence of hydronephrosis. The kidney is atrophic with increased cortical echogenicity. A subcentimeter lower pole simple renal cyst is noted.The spleen measures 9.2 cm in length.There is mild ascites.
1. Increased hepatic echogenicity and nodular contour consistent with cirrhosis. Scattered hepatic cysts.2. Mild ascites. 3. Subcentimeter gallbladder polyp.4. Atrophic kidneys with bilateral simple renal cysts. 