There is an extensive abnormality involving the left lobe of the liver. This is composed of ill-defined, predominantly peripherally located hypoattenuating coalescing masses. No convincing enhancement is demonstrated. Vessels pass through this abnormality. There is associated capsular retraction in segment IVb anteriorly. In addition there is patchy differential enhancement in the liver in the portal venous phase between the left and right lobes. The right lobe is hypertrophied measuring up to 22.6 centimetres in maximum caudocranial dimension. No discrete arterially enhancing lesion is demonstrated. There is extensive ascites. Free fluid extends down both paracolic gutters into the pelvis. The SMV, splenic vein, and portal vein are patent. The spleen is large measuring up to 16.7 cm in maximal craniocaudal dimension. There is a simple cyst interpolar region of the left kidney. The right kidney, pancreas, and adrenal glands are unremarkable. Bowel is unremarkable. No concerning bone lesion is demonstrated. The lung bases are clear. Incidental note is made of a Morgagni hernia containing fat.
Impression: Features most in keeping with epithelioid haemangioendothelioma in the left lobe of liver. Peripheral cholangiocarcinoma is the main differential. MRI should be performed for further characterisation.