Male; 60 years old. Reason: h/o hemangioma, assess for interval change LIVER: The liver has a nodular contour. Liver measures 18.0 cm in length. The parenchyma is normal in echotexture. There is no focal hepatic mass identified.The portal vein is patent and demonstrates normal directional flow with a peak velocity of 0.25 m/sec.BILIARY TRACT: The gallbladder contains layering sludge. There is no cholelithiasis, wall thickening or pericholecystic fluid. Common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 6.9 cm. The cortex is normal in echogenicity but thin. No shadowing calculi or hydronephrosis is present. 1.2 x 0.9 x 1.3 cm slightly hypoechoic structure is seen in the right kidney. There is no associated abnormally increased vascular flow. The left kidney measures 13.8 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 12.6 cm. in length. OTHER: Bilateral pleural effusions.
1.Hepatomegaly.2.No hepatic hemangioma is identified and no prior imaging was available for comparison at the time of this dictation.3.Right kidney lesion likely represents a prominent column of Bortan but follow up with contrast-enhanced CT or MRI is recommended to exclude underlying neoplasm.4.Bilateral pleural effusions.