Should I have an ERCP to see if I have cancer?
IMPRESSION:
1. Findings within the liver and biliary tree consistent with
patient's history of primary sclerosing cholangitis. There is
enhancement and thickening of the biliary tree in the hilar region.
Cholangiocarcinoma cannot be excluded.
2. Prominent periportal lymph nodes.

DISCUSSION: Abdominal MRCP performed before and after the
intravenous administration of 14 mL MultiHance. Comparison is made
to CT dated 12/22/2010. Indication is PSC.

Imaging through the abdomen shows mild abnormal liver morphology
which is likely due to patient's underlying biliary tree disease.
There is mild irregularity of the biliary tree with dilated intra and
extrahepatic bile ducts which show narrowing in the hilar region
where there is thickening of the biliary tree and prominent
enhancement. The intrahepatic duct dilation is increased since the
2010 exam. Cholangiocarcinoma cannot be excluded. The branch of the
right hepatic artery courses posterior to the thickening at the
hilum. The hilar thickening is just anterior to the portal vein
bifurcation. Hepatic veins are normal. The gallbladder is
surgically absent. The spleen is normal in size. Kidneys and
adrenal glands are normal. The pancreas and pancreatic duct are
normal. No ascites. There are prominent periportal lymph node