Presentation
Elevated liver enzymes.
Patient Data
The liver has a nodular margin in keeping with cirrhosis. No hepatic mass is identified in the current study.
Some collateral vessels are noted in upper perigastric and distal paraesophageal regions.
A few stones are seen in the gallbladder less than 10 mm.
The spleen is enlarged, and its cephalocaudal height is measured 155 mm.
The left kidney is relatively small and shows uneven parenchymal atrophic changes. A 27 mm parapelvic cyst is evident in the left kidney. There is also a 3mm stone in the middle calyx of the left kidney. Furthermore, the left-sided abdominal muscles, especially posteriorly, are atrophic, and an incidental left-sided superior lumbar hernia containing fat is noted (history of left sided percutaneous nephrolithotomy).
A 25 mm nodule is seen at the left adrenal gland. Its mean attenuation value on non-contrast images measured 4 HU, inferring benign adenoma.
Case Discussion
Cirrhosis with evidence of portal hypertension and splenomegaly.
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