Radiology
The enhanced CT scan of the patient’s chest and abdomen revealed multiple cavity-like lesions in both lungs, with bilateral infectious lesions that were more prominent in the right lung. Additionally, enlarged lymph nodes were detected in the left supraclavicular fossa, right hilum, and mediastinum. A lesion was also found at the porta hepatis, which had an indistinct border with the pancreas and resulted in the narrowing of the portal vein. Hypodense lesions were also spotted in the liver (figure 1).
The enhanced MR scan of the upper abdomen revealed several abnormalities. There were partial ring-enhancing lesions in the liver, a lesion in the porta hepatis with unclear borders between it and the pancreas and liver, and involvement of the portal vein. Concurrent liver cysts were also present. The gallbladder displayed a heterogeneous signal, and enlarged lymph nodes were detected in the retroperitoneum (figure 2).
The whole-body PET-CT examination revealed localized thickening of the gallbladder neck with increased FDG metabolism and a cystic lesion in segment S3 of the liver that also showed increased FDG metabolism (figure 3). Multiple cavity-like lesions were detected in both lungs, with the consolidative cavity lesion in the right lung exhibiting increased FDG metabolism as well. There were multiple lymph nodes with increased FDG metabolism in the bilateral supraclavicular areas, mediastinum, right hilum region, retroperitoneum adjacent to the abdominal aorta, and bilateral skeletal vascular areas (figure 4). It is necessary to differentiate between potential tumors in the liver and the gallbladder.