63-year-old woman with history of multiple myeloma and endometrial cancer, pancreatic ductal dilatation and cystic lesion seen on CT. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in signal and morphology. There are gallstones, otherwise the gallbladder is normal. There is no intra or extrahepatic biliary ductal dilatation. Portal venous patient.SPLEEN: No significant abnormality noted.PANCREAS: 16 x 10 mm T2 hyperintense lesion in the tail of the pancreas (7/25) is noted with septations, not clearly communicating with the duct. Additionally, there is a 9 mm area of T2 hyperintensity (7/30) in the pancreatic head. The pancreatic duct is mildly prominent at the head but appears normal distally.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The hypoattenuating lesion seen in the head of the pancreas on the prior CT appears to be within the medial duodenal wall (7/41) and measures 8 x 6 mm. This cystic area invaginates the duodenal wall and appears to be mostly within the bowel lumen. The small bowel and colon are otherwise normal.BONES, SOFT TISSUES: Soft tissue nodule in the left breast (14/237) noted measuring approximately 19 mm.OTHER: No significant abnormality noted.
1.Cystic area within the medial duodenal wall near the ampulla with prominence of the proximal pancreatic duct. No mass identified, however this finding is nonspecific, possibly representing a periampullary cyst, a duodenal diverticulum, or choledochocele.2.Cystic lesion in the pancreatic tail, possibly a serous or mucinous cystadenoma or a nonfunctioning islet cell tumor. Imaging follow-up warranted.3.Third cystic lesion in the pancreatic head favored to represent an IPMN.4.Left breast mass, please correlate with mammographic history.5.Contrast extravasation as described above.