History of hepatic and pancreatic cysts. Evaluate for progression. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in size and morphology. There are multiple simple cysts throughout the liver. The largest lesion is a complex cystic lesion demonstrating internal debris and signal suggestive of prior hemorrhage, measuring approximately 12.5 x 11.5 cm (series 7/41), compared to 15.3 x 15.1 cm previously. On postcontrast subtraction images it demonstrates no internal enhancement. Again this may represent a complex cyst or biliary hamartoma. It causes mild local mass effect on the adjacent duodenum and common bile duct without evidence of obstruction.No biliary ductal dilatation. Contracted gallbladder. No suspicious liver lesion.SPLEEN: No significant abnormality noted.PANCREAS: The pancreatic tail multiloculated cystic lesion measures 5.9 x 3.6 cm (series 7/31), compared to 6.0 x 3.1 cm previously. There is suggestion that it communicates with the main pancreatic duct which is normal in caliber. Otherwise the pancreatic parenchyma is unremarkable.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small umbilical fat-containing hernia and diastases of the rectus abdominis musculature.OTHER: No significant abnormality noted.
1.Multiple benign-appearing liver cysts are unchanged. Complex cyst versus giant biliary hamartoma demonstrates interval decrease in size.2.No significant change in the pancreatic tail cystic lesion likely communicating with a normal caliber main pancreatic duct and representing a side-branch IPMN versus less likely a serous cystadenoma. No suspicious post-contrast enhancement.