58-year-old male with abdominal pain and weight loss. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Mild dilation of the main pancreatic duct diffusely, greatest in the body were measures up to 5 mm. There is mild relative narrowing seen at the junction of the body and head where the duct is tortuous, but there is no definite stricture. There is a 5 x 3 mm cystic lesion in the uncinate process which demonstrates connection to the main pancreatic duct via a small side branch, most suspicious for side branch intraductal papillary mucinous neoplasm. No suspicious features on postcontrast images. The dilation of the main pancreatic duct raises the question of combined type intraductal papillary mucinous neoplasm. Normal physiologic response to secretin.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: 2.4 x 2 cm cystic lesion in the inferior pole the left kidney with small amount of intrinsic high T1 material dependently, likely due to hemorrhage and/or proteinaceous debris. The lesion also contains a few enhancing septa inferiorly. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Findings suspicious for side branch IPMN in the uncinate process with mild dilation of the main pancreatic duct, raising the question of combined type IPMN. Continued follow-up is recommended.2. Complex cyst in the left kidney with findings suggestive of a Bosniak 2F lesion, at least one-year follow-up with renal protocol MRI is recommended.