72-year-old female patient status post Whipple in May 2009 for an IPMN and history of pancreatic cyst. Surveillance imaging. ABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes of a Whipple procedure.SPLEEN: No significant abnormality noted.PANCREAS: Postsurgical changes of a Whipple procedure. There is a 7 x 3 mm cystic, nonenhancing focus within the pancreatic body which appears to communicate with the main pancreatic duct and likely represents a sidebranch IPMN, not definitively visualized on the prior examination (image 41, series 10). An additional cystic lesion within the pancreatic tail compatible with a sidebranch IPM is also slightly larger in size. Stable branching prominence of the pancreatic duct within the distal pancreatic tail.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: Stable size of a reference porta hepatis lymph node measuring 1.4 x 1.2 cm (image 15, series 5), previously 1.4 x 1.2 cm. Scattered prominent lymph nodes in the retroperitoneum are also stable to mildly increased in size.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Post-surgical sequela within the ventral abdominal wall. OTHER: No significant abnormality noted.
1.Enlarging cystic lesions without suspicious features within the pancreas likely represent multiple sidebranch IPMNs.2.Mildly enlarged retroperitoneal lymph nodes may be reactive in etiology.