Pancreatic cysts. Abdominal pain. Recently found to have pancreatic, omental and lung masses status post exploratory laparotomy. ABDOMEN:LIVER, BILIARY TRACT: The liver is smooth in contour and normal in morphology. No focal hepatic lesion is identified. Artifact from a biliary stent is identified.SPLEEN: No significant abnormality noted.PANCREAS: Within the pancreatic head, there is a round, smoothly marginated, solid, T2 hyperintense lesion with minimal central necrosis and delayed enhancement measuring 2.5 x 1.8 cm (series 31, image 56). The SMA, SMV and portal vein are not involved. Two well defined, nonenhancing, T2 hyperintense cystic lesions are identified within the pancreatic body abutting the main pancreatic duct (series 501, image 25), the largest measuring 2.2 x 1.6 cm. The pancreatic duct is not significantly dilated. The pancreatic head appears edematous with some surrounding inflammation. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is no evidence of bowel obstruction. Mesenteric edema is present. Peritoneal nodularity is identified on series 1204, image 354.BONES, SOFT TISSUES: No suspicious osseous lesion is identified.OTHER: A right lower lobe nodule with rim enhancement measures 2.3 x 2.0 cm (series 702, image 139), incompletely imaged, previously identified on CT chest January 6, 2015. Left basilar subsegmental atelectasis. Small bilateral pleural effusions. Nonspecific 5 mm well-circumscribed left breast enhancing nodule (series 1204, image 524).
1.Solid T2 hyperintense, enhancing pancreatic head lesion, for which differential considerations including neuroendocrine tumor (Given the lesion is well defined and does not frankly invade surrounding structures) versus adenocarcinoma. Correlation with biopsy results, CA 19-9 levels recommended. 2.Cystic lesions in the pancreatic body, possible pseudocysts versus mucinous neoplasm.3.Right lower lobe lung nodule better evaluated on CT. 4.Nonspecific peritoneal nodularity.