A large hypodense lesion in segment V of the liver, with very subtle enhancement appreciable in the delayed phase of the contrast study, whilst the central portion remains unenhanced. Portal vein is patent. No CT evidence of cirrhosis or portal hypertension. No hepatic capsular retraction. No porta hepatis enlarged lymph nodes.
Large volume ascites.
Interpretation: Imaging appearance can be seen with liver metastasis (hypovascular) from unknown primary, intrahepatic cholangiocarcinoma is also possible. Hepatic lymphoma is less likely in the differential diagnosis.