Female 25 years old; Reason: Liver pathology History: Acutely elevated AST/ALT, c/f acute liver injury LIVER: The liver measures 16.5 cm in length. There is normal echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. There is a hyperechoic lesion seen within the left lower of the liver measuring 2.3 cm x 1.3 cm x 2.0 cm. This has no internal vascularity. The main portal vein is patent with normal hepatopetal flow measured at 25.2 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 1.1 mm. No stones are seen. No pericholecystic fluid. Negative sonographic Murphy's sign. The common bile duct measures 3.3 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 8.7 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.7 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 12.3 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: A left pleural effusion is identified. No ascites.
1. There is a hyperechoic lesion identified in the left lobe of the liver. While this may represent a benign hemangioma, this lesion is incompletely characterized on ultrasound and recommend cross-sectional imaging for further characterization.2. Bilaterally the kidneys have increased echogenicity compatible with medical renal disease.3. A left pleural effusion is identified.