liver Rising LFF's.

HISTORY: Rising LFF's.

 FINDINGS: Images 1-6 are transverse scans of the liver.  In Image 1

notice there is a clear cut area of refractive shadowing (arrowheads)

seen adjacent to a focal echogenic lesion.  Images 2-5 demonstrate fine

punctate areas of increased echogenicity consistent with calcifications

(arrows).  Notice the hypoechoic halo around the inferior margin of the

lesion seen on Image 5.  Image 6 is a transverse scan of the left lobe

of the liver at the level of the celiac axis.  Notice the celiac axis

adenopathy.

DIAGNOSIS: Metastatic mucinous adenocarcinoma of the colon.

DISCUSSION: Calcification may occur in a variety of hepatic metastases,

but it is most commonly encountered with mucinous adenocarcinoma.  Note

the typical sonographic features of solid masses of the liver with

refractive shadows and hypoechoic halos.  Regional lymphadenopathy can

be also noted with a wide variety of metastatic diseases, but given the

punctate areas of calcifications metastatic colon cancer is the most

likely diagnostic possibility.