What is the differential diagnosis for these lesions?
The main differential is between metastases and abscesses. Clinical history and age is important but aspiration would confirm the diagnosis.
Multiple hypodense (30-50HU) lesions in the liver that demonstrate nodular, margins with internal, enhancing septations and measure 30-50HU in density. The lesions are predominantly subcapsular:
- segment IVa - 34 x 24mm
- segment VII - 33 x 24mm
- segment II - 31 x 31mm
A further 6mm hypodensity is noted in liver segment VII, it is unclear whether this is a related lesion or not. Segemental perfusion abnormalities are noted in the right liver on arterial phase and with liver segments II/III on portal venous phases.
Remaining imaged hollow and solid abdominal viscera is unremarkable. BIbasal atelectasis. Right pleural thickening/small pleural fluid collection.