Female 21 years old Reason: Hx of pancreatic cyst, recent CT showing enlargement History: Pancreatic cyst ABDOMEN:LIVER, BILIARY TRACT: Diffuse hepatic steatosis.SPLEEN: No significant abnormality noted.PANCREAS: There is a 4.7 x 5.3 cm T2 hyperintense lesion centered on the distal pancreatic body/pancreatic tail which does not demonstrate definite communication with the pancreatic duct. There is a 1.1-cm nonenhancing nodular focus on the nondependent wall (series 7, image 23) that is isointense to the remainder of the lesion. This is nonspecific but may represent a mucin globule. There is a nonenhancing septation in the inferior aspect (series 4, image 16). There is no debris within the lesion. There is no pancreatic duct dilatation. Post administration of secretin the pancreatic duct demonstrates normal physiologic response. The pancreatic parenchyma upstream from the cystic lesion demonstrates loss of normal intrinsic T1 hyperintensity, mildly increased T2 signal and is relatively hyperenhancing and appears to retain contrast relative to the remainder of the pancreas. There are no surrounding peripancreatic inflammatory changes.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mildly prominent juxtaphrenic lymph node is nonspecific.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1.Cystic pancreatic lesion with nonenhancing internal nodule and septation. The appearance is worrisome for a mucinous cystic neoplasm. While pancreatic pseudocyst is a differential consideration, given the absence of a definite history of prior acute pancreatitis this is felt to be much less likely. 2.Abnormal signal in the upstream pancreas is likely due to a combination of edema and perfusional variation secondary to element and an element of obstruction from the above described cystic lesion. While very early acute pancreatitis could have a similar appearance this is felt much less likely given the absence of peri-pancreatic inflammatory changes.