Reason: Evaluate progression of hepatic and pancreatic cysts History: history of large cysts, abdominal pain, early satiety ABDOMEN:LIVER, BILIARY TRACT: Multiple simple cysts are seen throughout the liver, the largest of which measures 15.1 x 15 .3 cm, previously 15.1 x 14.4 cm (image 24, series 8). This largest cyst is again filled with debris with intrinsic T1 hyperintensity and T2 hypointense rim suggesting prior hemorrhage. No mural nodule or enhancing solid component is seen within this cyst. This is again causes mass effect on the right kidney, IVC, common duct, pancreas, and duodenum without evidence of obstruction, appearing similar to the prior study.No intrahepatic or extrahepatic biliary duct dilation. The portal vein is patent.SPLEEN: No significant abnormality noted.PANCREAS: Reference, multiloculated cystic lesion in the pancreatic tail measures 5.8 x 3.3 cm, previously 5.4 x 2.6 cm (image 17; series 10). There is again some enhancement of the septations, however no mural nodular enhancement. Differential considerations include a serous cystadenoma as well as a branch-type IPMN. No pancreatic duct dilation is seen.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mass effect on the right kidney from the previously described hepatic cysts, appearing similar to the prior study. No significant abnormalities noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1.No significant change in multiple benign appearing liver cysts, the largest of which again contains internal debris and causes mass effect on the surrounding structures without obstruction.2.Slight interval increase in size of reference cystic lesion in the pancreatic tail which may represent a serous cystadenoma or IPMN.