66-year-old female with pancreatic cystic lesions with high CEA, abdominal pain, weight loss. ABDOMEN:LIVER, BILIARY TRACT: No focal liver lesions. Common bile duct is normal in caliber. Common bile duct has a bulbous appearance at the level of the ampulla which may represent a small choledochocele.SPLEEN: Splenule.PANCREAS: Numerous T2 hyperintense foci, the largest within the the uncinate process, head and body of the pancreas. An elongated cystic lesion in the head of the pancreas is appears multiseptated measuring 3.9 x 1.5 cm.. The main pancreatic duct is normal in caliber.ADRENAL GLANDS: Left myelolipoma.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Soft tissue nodule in the abdominal subcutaneous wall measuring 1.9 x 1.9 cm.OTHER: No significant abnormality noted.
1.Large multiseptated, lobular, elongated cystic mass in the head of the pancreas. Differential includes a side branch type IPMN, serous cystadenoma, or possibly a mucinous cystadenoma.2.Cystic lesion in the body of the pancreas is felt to represent a sidebranch type IPMN. Additional small cystic lesions are also felt to represent side branch type IPMN.