Plain-Language Explanation of Mrs. Savithri's Ultrasound Report

What Each Finding Means

• Normal size and texture. No tumors seen inside the liver.
• However, there is mild central IHBRD - this stands for Intrahepatic Biliary Radicle Dilatation, meaning the small bile ducts inside the liver are slightly wider than normal. This happens when something is partially blocking the bile from draining out properly (explained further below).

• The gallbladder has been removed (post-cholecystectomy).
• The CBD (Common Bile Duct) - the main tube that carries bile from the liver to the intestine - is dilated (widened) at 11.5 mm (normal is less than ~8 mm). This is a sign of obstruction or pressure on the duct.
• Most importantly: there is a 2.4 x 2.0 cm soft tissue mass in the periportal region (the area around the portal vein, which is the main blood vessel going into the liver). This mass:
  • Has its own blood supply (internal vascularity) - a feature typical of a tumor or active deposit
  • Is wrapping around (encasing) the portal vein
  • Is pressing on (compressing) the lower end of the CBD, which explains why the bile duct is dilated

What this means in simple terms: A cancerous lump (most likely a lymph node with cancer spread, or a direct tumor deposit) has grown back near the liver's main blood vessel and is squeezing the bile duct, causing a bile flow blockage.

• Head and neck appear normal. No obvious pancreatic involvement.

• Normal. No concern.

• Both kidneys are normal in size, texture, and function on ultrasound.
• No kidney stones or masses.
• A small 15x14 mm cyst is seen in the upper part of the right kidney - this is a simple, benign (non-cancerous) cyst, very common in older adults, and not a concern.

• Empty at the time of scan. Wall is normal. No stones or masses.

• Shrunken (atrophic) and not clearly seen - expected in a 70-year-old woman after menopause.

The Most Concerning Finding

• Involves the skin, the fat under the skin, and the muscle layer
• Extends inward all the way to the pro-peritoneal space (just outside the inner lining of the abdomen)

In plain terms: A sizeable cancerous deposit has grown back and is spreading through the layers of the abdominal wall on the right side. This is called a soft tissue/abdominal wall recurrence of gallbladder cancer - the cancer has come back at or near the original surgical site.

The Radiologist's Summary (Impression)

1. Periportal lymph node deposit / tumor deposit - A cancer deposit near the portal vein is dilating the bile duct (CBD) and causing mild bile duct dilatation inside the liver (IHBRD). This is local lymph node recurrence of the gallbladder cancer.
2. Mild central IHBRD - Mild widening of bile ducts inside the liver, secondary to the obstruction described above.
3. Abdominal wall soft tissue deposit - A large (4.4 x 3.9 cm) cancer deposit in the right abdominal wall extending through skin, fat, muscle, and towards the peritoneal lining. This is a local recurrence/implantation metastasis at the surgical site.

What This All Means Overall

• Inside the abdomen near the liver's blood supply (periportal region), pressing on the bile duct
• In the abdominal wall on the right side (likely at or near the old operation site)

Important note: This explanation is for understanding purposes only. All treatment decisions must be made by Mrs. Savithri's medical team, who have access to her full history, previous scans, and clinical examination.