Male 75 years old Reason: 75 yo male with hx of pancreas lesion; please eval for changes History: pancreas lesion ABDOMEN:LIVER, BILIARY TRACT: Status-post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: Clustered cystic lesions again noted in the region of the pancreatic head and uncinate process. The largest measures 1.3 x 1.5 cm (series 3, image 31) and contains a solid focus on the nondependent wall. While this may represent debris a solid nodule cannot be excluded, particularly in the absence of intravenous contrast.Cranial to this there is a second 1.7 x 1.4 cm lobulated cystic lesion without evidence of internal nodule. Both lesions demonstrate interval decrease in size of the cystic component compared to prior study. The solid component in the more caudally located lesion is unchanged in size.Additional tiny cystic lesions are not significantly changed compared to prior study.The pancreatic duct is not dilated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable appearance on renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1.Clustered cystic lesions predominantly in the pancreatic head and uncinate process. There has been an interval decrease in size of the cysts compared to prior study. One of the lesions contains a solid component. While this may represent a complex IPMN, the possibility of malignant degeneration cannot be excluded, particularly in the absence of intravenous contrast. Correlation with results of endoscopic sonography recommended.