History of metastatic colon cancer to the pancreas status post Whipple. Fatty liver. Elevated CEA. PET CT reported suspicious liver lesions without MR correlate. ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis. Status post cholecystectomy. Normal liver morphology without a focal lesion or biliary ductal dilatation. The portal vein is chronically thrombosed with reconstitution by multiple small collateral vessels in the porta hepatis.SPLEEN: No significant abnormality noted.PANCREAS: Postsurgical changes from Whipple procedure. The residual pancreatic tail duct is dilated up to 4 mm without significant parenchymal atrophy. There are small cystic foci which may represent side branch ectasia or small IPMNs measuring less than 1 cm. It demonstrates decreased intrinsic T1-weighted signal intensity with normal enhancement and no evidence of acute inflammation. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Simple appearing bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple prominent mesenteric lymph nodes are not significantly changed compared to the 2/23/2016 CT.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Severe hepatic steatosis without a discrete suspicious lesion evident. The abnormality on PET/CT could have been related to differential tracer deposition given the patient's chronic portal vein thrombosis, however continued surveillance imaging is recommended. 2.Multiple prominent mesenteric lymph nodes are not significantly changed compared to the 2/23/2016 CT.3.Chronic portal vein thrombosis with cavernous transformation.4.Postsurgical changes from Whipple procedure with stable prominence of the distal pancreatic duct.