Surveillance for IPMN. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology. Segment 4A cyst. Segment 2 lobular arterially enhancing lesion which is isointense to liver parenchyma on T1-weighted and mildly hyperintense on T2-weighted ages. It becomes isointense to liver parenchyma on portal venous and delayed phase imaging, compatible with a focal nodular hyperplasia. It measures 4.9 x 4.3 cm.The gallbladder is diffusely filled with gallstones. No specific evidence of gallbladder inflammation. There are multiple filling defects within the distal common bile duct compatible with choledocholithiasis. The common duct measures 9 mm, compared to 7 mm previously.SPLEEN: The spleen is normal in size and signal intensity.PANCREAS: The pancreas is normal in morphology and signal intensity. The punctate focus adjacent to the main pancreatic duct (series 7/59 and series 9/27) is unchanged. This may represent a very small side branch IPMN.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Large exophytic left renal septated cyst without suspicious postcontrast enhancement. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace pleural effusions.
1.Cholelithiasis without evidence of gallbladder inflammation. Choledocholithiasis with mild-moderate biliary ductal dilatation, increased from the prior.2.No significant >5 mm cystic pancreatic lesion is seen on today's study. Previously described punctate pancreatic head cystic focus is unchanged.3.Minimal increase in size of the segment 2 lesion, compatible with focal nodular hyperplasia.