66-year-old female with pancreatic mass last imaged on 9/8/2016 (endoscopic ultrasound). ABDOMEN:LIVER, BILIARY TRACT: Perihepatic ascites. The common bile duct is normal in caliber. No focal liver lesions.SPLEEN: Perisplenic ascites.PANCREAS: Mass like enlargement of the head of the pancreas is again noted although now decreased when compared to the prior exam dated 7/7/2016. There is decrease in surrounding T2 edema type signal. There is also decrease in duodenal wall thickening. The main pancreatic duct is normal in caliber. There is normal excretory response to secretin. There is decreased compliance of the main pancreatic duct with administration of secretin.ADRENAL GLANDS: Mild left adrenal gland thickening.KIDNEYS, URETERS: T2 hyperintense cysts are noted bilaterally. No hydronephrosis or perinephric inflammation.RETROPERITONEUM, LYMPH NODES: Unchanged T2 hyperintense elongated cystic focus in the left para-aortic region, may be lymphatic in origin. Scattered mildly prominent para-aortic lymph nodes are noted.BOWEL, MESENTERY: Small volume of abdominal and pelvic ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Partially imaged lobular pelvic lesion may represent a large uterine fibroid. Trace bilateral, right greater than left, pleural effusion. Left lower lobe consolidation may reflect infection.
1.Mass like enlargement of the pancreatic head is again noted with interval decrease in size, surrounding interstitial edema, and duodenal wall thickening when compared to prior examination. Differential diagnosis includes malignant or benign etiologies; consider granulomatous pancreatitis. Correlation with histopathology is recommend.2.Left lower lobe consolidation may represent infection.