54-year-old male with gallbladder mass identified on outside preemployment ultrasound. LIVER: Evaluation of the liver is very limited by high position. There is some heterogeneity involving the left lobe of the liver although a defined mass cannot be seen with certainty.BILIARY TRACT: Within the gallbladder fossa there is a round area of mixed echogenicity measuring 5.1 x 5.3 x 6.3 cm which does not obviously change in appearance with change in patient position, although no normal gallbladder lumen with fluid is identified. The adjacent liver appears mildly hypoechoic as well. Although a gallbladder with significant sludge could potential he have this appearance, given that the patient is asymptomatic, findings are highly worrisome for a gallbladder carcinoma.There is, however, no intrahepatic ductal dilatation. Common duct is mildly enlarged for age.PANCREAS: Incompletely visualized due to bowel gas. Pancreatic body is normal.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Limited views of left kidney demonstrate no abnormality.Evaluation of the retroperitoneum demonstrates evidence for para-aortic retroperitoneal adenopathy. The largest node visualized by ultrasound measures 2.7 cm in greatest diameter.
Findings of large mass in the gallbladder fossa with adjacent liver altered echogenicity which may be due to invasion by gallbladder carcinoma. There is also heterogeneity of the lateral left lobe of the liver and small mass cannot be excluded.Given the constellation of findings above, would recommend CT for further evaluation.