Image of the Month—Quiz Case

Marcotte E, Afaneh C, Pomp A, et al. — Mon, 01 Apr 2013 00:00:00 GMT

A 50-year-old woman of Caribbean descent presented to an outside hospital with a history of several months of recurrent postprandial right upper quadrant pain associated with nausea and vomiting. Her white blood cell count and liver function test results were within normal limits. She underwent abdominal ultrasonography and a computed tomography scan of the abdomen, which showed cholelithiasis and a questionable cystic dilatation of the common bile duct. She requested a transfer to the Weill Cornell Medical Center. Serologic test results for Echinococcus were negative. A magnetic resonance cholangiopancreatography was ordered to characterize the anatomy. This showed a roundlesion centered in the hepatic hilum measuring 1.9 × 1.9 × 2.1 cm with thin internal septations (Figure 1). Although it was in proximity to biliary structures, a direct communication was not visualized. There was no evidence of lymphadenopathy. She was scheduled for a laparoscopic cholecystectomy and resection of the lesion (Figure 2).

Image of the Month—Diagnosis

Mon, 01 Apr 2013 00:00:00 GMT

JAMA Surgery: Ultrasonography Topic Collection

Image of the Month—Quiz Case

Image of the Month—Diagnosis