Female; 74 years old. Reason: 74yp F w/ adenocarcinoma, evaluate for cholestasis/transaminitis cause History: as above LIVER: The liver is enlarged measuring 20.8 cm in length. There is an ill-defined 4.8 x 2.0 by 2.5 cm heterogeneous but predominantly hypoechoic focus near the gallbladder fossa. There is some internal vascularity within this focus which may represent the course of normal vessels. Please refer to the recent CT for additional findings. The main portal vein is not definitely seen but appeared patent on CT. There is portal venous branch flow suggested with a somewhat decreased velocity of 10 to 20 cm/sec.BILIARY TRACT: The gallbladder is nondistended. There is no cholelithiasis or gallbladder wall thickening. The gallbladder wall measures 3 mm. There is no intrahepatic or extrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 7.6 cm in length.RIGHT KIDNEY: The right kidney measures 9.2 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. LEFT KIDNEY: The left kidney measures 10.9 cm in length. There is no hydronephrosis or shadowing renal stone. In the superior pole of the kidney is a 2.7 x 2.4 x 2.7 cm predominantly cystic lesion with nodular components along the wall. This lesions correlates with that seen on the recent CT.
1.Hepatomegaly and increased parenchymal echogenicity suggestive of underlying parenchymal dysfunction/steatosis. Ill-defined, heterogenous, hypoechoic focus near the gallbladder fossa could represent an area of focal fatty sparing but this finding is nonspecific. MRI is recommended for further characterization.2.2.7 cm left renal mass has an ultrasound appearance concerning for primary renal neoplasm.