- The liver shows cirrhotic configuration with irregular nodular outline and hypertrophied left and caudate lobes.
- The left liver lobe segments II and III shows a large ill-defined infiltrative mass lesion having irregular outline and mixed signals with areas of breaking down within. This lesion roughly measures 16 X 11.5 X 12 cm in its maximal axial cross sectional & craniocaudal dimensions and causing contour bulge. It elicits hypointense T1, intermediate to high T2 as well as restricted diffusion. The lesion shows intense post-contrast enhancement in the arterial phase with washout in the portal-venous and delayed phases.
- A few smaller lesions of similar signal and enhancement pattern are seen scattered in the right lobe, the largest is at segment VIII (hepatic dome as well as juxta-caval) as well as segment VI and segment V. They show arterial enhancement with washout in the portal-venous and delayed phases with coronal / capsular enhancement.
- Multiple innumerable regenerative / dysplastic small hypervascular and arterially enhancing nodules are seen scattered in both liver lobes.
- Malignant thrombosis of the left portal vein with similar malignant enhancement criteria.
- No evident intra-hepatic or extra-hepatic biliary tree dilatation.
- The spleen is enlarged, with no definite focal lesion.
- The right kidney shows a 4.5 X 3.3 cm cortical cyst, otherwise, normal both kidneys.
- Normal pancreas.
- Mild to moderate ascites is noted, mainly peri-hepatic.
- Multiple enlarged para-aortic, celiac and porta hepatis lymph nodes are noted, the largest is 3.5 X 2.5 cm.