64-year-old female with pancreatic lesion noted on abdominal ultrasound, abdominal pain ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without specific evidence of cholecystitis. There are subcentimeter T2 hypointensities within the left and right lobe of the liver most compatible with cysts. Trace amount of perihepatic fluid.There is a focus of susceptibility artifact in the inferior right lobe of the liver that is nonspecific.SPLEEN: Trace amount of perisplenic fluid.PANCREAS: There is loss of the intrinsic T1 signal of the pancreatic parenchyma. There is a hypoenhancing, intrinsic T1 and T2 isointense enhancing mass within the body of the pancreas measuring up to 5.1 x 4.0 x 4.7 cm (series 1103, image 35). There is dilation of the distal pancreatic duct measuring up to 8 mm. There is at least 180 degree encasement of the proximal SMA and common hepatic artery. There is encasement of the SMV with marked mass effect without evidence of occlusion. The splenic vein is chronically occluded with gastric varices present. The portal vein is patent.Pancreatic divisum anatomy is noted. ADRENAL GLANDS: Nodularity/thickening of the left adrenal gland is nonspecific.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderately prominent left para-aortic lymph nodes measuring up to 8 mm in short axis.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Pancreatic mass in the body of the pancreas as described above is suspicious for cancer. Focal pancreatitis may result in these findings as well. An endoscopic ultrasound is recommended for further evaluation. 