42-year-old woman with history of pancreatic lesion. ABDOMEN:LIVER, BILIARY TRACT: The liver appears normal in signal and morphology. Cholelithiasis without evidence of cholecystitis. No intra or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: The tail of the pancreas (6/17) there is a 38 x 34 mm homogenous markedly T2 hyperintense lobulated lesion without enhancement. A few thin internal septations are noted, but there is no nodular component. Along the medial aspect there is a small, tail-like extension towards the pancreatic parenchyma (900/22), but lesion otherwise does not clearly communicate with the pancreatic duct. This lesion measured 34 x 31 mm on the prior exam and has significantly increased in size since exam in 2008 (when measured up to 1.3 cm). The remainder of the pancreas appears normal and there is no pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Simple ovarian cysts noted.
Nonenhancing cystic pancreatic lesion containing thin septations located in the tail of the pancreas, gradually increasing in size over serial exams. Based on imaging appearance, this could represent a oligocystic or macrocystic variant of serous cystadenoma but a purely cystic mucinous cystic neoplasm cannot be entirely excluded (the cystic components of lesion do not demonstrate variable or increased T1 signal). Please correlate with clinical findings and, given continued increasing size (lesion now measures up to 3.8 cm), consider repeat EUS/biopsy.