Reason: eval pancreatic mass for malignancy History: 25lb weight loss ABDOMEN:LUNG BASES: Multiple bilateral basilar lung nodules noted, better seen on recent CT chest abdomen and pelvis study.LIVER, BILIARY TRACT: There is a peripheral wedge-shaped T1 and T2 hypodensity in the right lobe of the liver with persistent contrast enhancement. This region remains indeterminant, attention on follow-up imaging. Mildly dilated common bile duct. Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: The pancreatic parenchyma is atrophic. There is cystic lesions in the pancreas correlating with changes of chronic pancreatitis seen on prior CT scan. Pancreatic duct of the head and uncinate process appears within normal limits. Pancreatic duct at the body and tail is not well visualized.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse thickening of the distal esophagus is again partially imaged, please correlate with endoscopy findings.BONES, SOFT TISSUES: The bone marrow are heterogeneous, consider PET scan.OTHER: No significant abnormality noted
1. Morphologic changes of the pancreas consistent with chronic pancreatitis. At least three adjacent fluid collections do not contain suspicious features, and are likely related to the chronic pancreatitis.2. There is a peripheral wedge-shaped T1 and T2 hypodensity in the right lobe of the liver with persistent contrast enhancement. This region remains indeterminant, attention on follow-up imaging. CT liver protocol may be useful as there will be less motion artifact.3. Diffuse thickening of the distal esophagus and pulmonary nodules are again partially imaged, and suspicious for neoplasm with metastatic disease.