38-year-old female with new acute leukemia, pancreatic head lesion on ultrasound ABDOMEN:LIVER, BILIARY TRACT: Perfusion abnormality of the posterior right hepatic segments. There is a persistent filling defect within the proximal right hepatic veins that may represent thrombus. Additional smaller foci within the proximal left hepatic veins suspicious for thrombus.SPLEEN: Mottled T2 signal and enhancement of the spleen may reflect known diagnosis of leukemia.PANCREAS: There is a small lymph node adjacent to the pancreatic head that likely represents the hypoechoic lesion identified on prior ultrasound. There is a T2 hyperintense cystic lesion in the distal body of the pancreas measuring 9 x 11 mm (series 9, image 22) with probable communication with the main pancreatic duct favored to represent side branch type IPMN. The main pancreatic duct caliber is normal.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered subcentimeter peripancreatic lymph nodes. No pathologically enlarged lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: T2 hyperintense cyst in the left hemipelvis may be adnexal in origin, incompletely evaluated.
1.Filling defects within the proximal right and left hepatic veins may represent thrombus. 2.Small lymph node adjacent to the pancreatic head that likely represents the hypoechoic lesion identified on prior ultrasound. 3.T2 hyperintense cystic lesion in the distal body of the pancreas with probable communication with the main pancreatic duct favored to represent side branch type IPMN.4.Mottled enhancement of the spleen may reflect known diagnosis of leukemia. No splenic vein thrombosis is present.Findings discussed with clinical service at 1155 on 11/9/2016.