Female 72 years old s/p whipple for IPMN in 2009 now w/ MRCP evidence of 2 new cysts (body and tail) increasing in size on last MRCP - please eval for increase in size of cysts. ABDOMEN:LIVER, BILIARY TRACT: Postoperative changes of Whipple are again noted. No focal liver lesion, biliary ductal dilation, or ascites. There is loss of liver parenchymal signal on out of phase imaging indicating hepatic steatosis.SPLEEN: No significant abnormality noted.PANCREAS: Postoperative changes of Whipple are again noted. The pancreatic tail is atrophic. The cystic, nonenhancing lesion within the pancreatic body measures 6 x 3 mm (series 1403, image 202), previously 7 x 3 mm. It again appears to communicate with the main pancreatic duct likely representing a side branch IPMN. The pancreatic tail the lesion also compatible with a sidebranch IPMN is unchanged in size (series 801, image 23).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: The reference porta hepatis lymph node measures 1.4 x 1.1 cm (series 901, image 23), previously 1.4 x 1.2 cm. Additional scattered prominent retroperitoneal lymph nodes are stable to mildly decreased in size.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes are again seen in the ventral abdominal wall.OTHER: No significant abnormality noted.
1.Stable size and appearance of cystic pancreatic lesions compatible with side branch IPMNs.2.Mildly enlarged retroperitoneal lymph nodes are stable to decreased in size.