Female 56 years old Reason: 56 yo F hx of cystic pancreatic lesion s/p distal pancreatectomy in 8/2013,EUS 5/2015 showed residual pancreas with chronic pancreatitis changes and a cystic lesion in uncinate process. 1 year f/u MRI to assess for growth, also eval for chronic pancreatic History: cystic lesion of pancreas, chronic pancreatitis ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. Hepatic and portal veins are patent.Status post cholecystectomy. Intrahepatic bile ducts and common bile duct are normal in caliber.SPLEEN: Status post colectomy. Probable residual splenic tissue adjacent to the left kidneyPANCREAS: Status post resection of the pancreatic tail. There is a subcentimeter cystic focus in the head of the pancreas measuring 9 mm that appears to communicate with the pancreatic duct and represents a small branch type IPMN.There is mild fatty atrophy of the pancreas.There is mild ductal irregularity of the pancreatic duct in the head of the pancreas in the region of calcifications previously noted.Upon administration of secretin, response is mildly blunted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: In the left kidney, there is a 9 mm partially exophytic lesion as seen on image 25/series 7. The lesion has questionable subtle enhancement. No hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Status post pancreatic tail resection and splenectomy. Small cystic lesion (9mm) in the pancreatic head with imaging features suggestive of a IPMN. Allowing for differences in modality the lesion is not significantly changed.2.Slightly blunted response to secretin in the setting of mild pancreatic atrophy.3.Cystic lesion in the left kidney has slightly suspicious features. The lesion is too small to fully characterize and a follow-up imaging study in 12 months can be performed.