Female 49 years old; History: 49F with DM2 and tobacco abuse p/w acute on chronic RUQ and LUQ cramping pain worse with certain positions not related to food intake, ?gallstones, ?cholecystitis. Evaluate for hepatobiliary pathology. LIVER: The liver measures 13.3 cm in length. There is increased and coarse echogenicity of the liver parenchyma. There is a well-circumscribed echogenic focus measuring approximately 1.3 x 1.2 x 1.1 cm in segment 8 of the liver. No intrahepatic ductal dilation is seen. The main portal vein is patent. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 3.2 mm. There are multifocal, discrete, nondependent hyperechoic polyploid masses within the gallbladder fossa. No pericholecystic fluid. The common bile duct measures 7.8 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10.3 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.2 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 12.0 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: No significant abnormality noted.
1. Coarse hepatic echotexture consistent with chronic liver disease/parenchymal dysfunction.2. Hyperechoic right lobe hepatic mass. While this may represent hemangioma, in the context of chronic liver disease is best considered indeterminate and dedicated cross-sectional imaging is recommended.3. Hyperechoic multifocal polypoid masses within the gallbladder fossa as described above also concerning for neoplasm. Further dedicated cross sectional imaging is recommended.