History of pancreatic and peribiliary cysts. Stomach and back pain. ABDOMEN:LUNG BASES: Dilated pulmonary artery redemonstrated, suggestive of pulmonary arterial hypertension.LIVER, BILIARY TRACT: Numerous peribiliary cysts are redemonstrated. They appear slightly increased in number, particularly centrally, and there has been growth of a now 3.0 cm central cyst. This cyst compresses the central ducts, and there is increased intrahepatic biliary ductal dilatation. However extrahepatic biliary ductal dilatation is new or increased, with the common duct measuring up to 9 mm.SPLEEN: No significant abnormality noted.PANCREAS: Multiple cystic lesions of the pancreas are redemonstrated, some of which have increased in size. The reference, largest lesion in the distal body measures 1.8 cm (series 1001, image 20), previously 1.4 cm.ADRENAL GLANDS: Bilateral adrenal thickening unchanged.KIDNEYS, URETERS: Bilateral renal cysts, slightly larger from the prior exam.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Increased size of multiple pancreatic cystic lesions, likely representing branch-type IPMNs.2.Increased intra and extrahepatic biliary ductal dilatation. Intrahepatic dilatation may at least in part relate to increased size of a central peribiliary cyst. However, there is also a new or increased dilation of the common duct up to 9 mm, which may reflect benign biliary stricture