Male; 52 years. Reason: F/U on cholangiocarcinoma CHEST:LUNGS AND PLEURA: Pulmonary nodule in left base (series 4 image 70), unchanged compared to 5/7/11MEDIASTINUM AND HILA: Subcarinal lymphadenopathy measuring 1.3 cm, unchanged. Other borderline enlarged mediastinal lymph nodes are not significantly changed.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Pneumobilia with right and left hepatic lobe internal metallic biliary stents extending into the duodenum. Soft tissue attenuation in the porta hepatis/gallbladder fossa is similar to prior.SPLEEN: Splenomegaly, measuring 17 cm.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Multiple enlarged and borderline enlarged retroperitoneal lymph nodes with retroperitoneal stranding are not significantly changed. Left para-aortic lymph node (series 3 image 128) measures 1.3 x 1.7 cm, unchanged. Partially calcified portacaval lymph node (series 3 image 26) measures 3 x 1.6 centimeters, unchanged.BOWEL, MESENTERY: Multiple borderline enlarged mesenteric lymph nodes.There may be a focal circumferential wall thickening of the cecum (series 3 image 153), raising the possibility of a primary mass as this would be atypical for metastases.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small free fluid.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1. Stable soft tissue attenuation in the porta hepatis/gallbladder fossa with periportal and retroperitoneal lymphadenopathy, consistent with known cholangiocarcinoma.2. Apparent focal circumferential wall thickening of the cecum, may represent primary neoplasm as this is atypical for metastases. Recommend correlating with colonoscopy.