Female; 62 years old. Reason: post prandial abdominal pain, weight loss, history of NF 2. ABDOMEN:LIVER, BILIARY TRACT: Scattered arterially enhancing foci are identified in the liver which do not persist on delayed imaging and are thus nonspecific. The largest of these measures 1.2 x 1.3 cm in the dome of the diaphragm and has some intrinsic T2 signal (series 1002, image 727). Patent hepatic vasculature. No biliary ductal dilatation. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: See discussion below. BOWEL, MESENTERY: Multilobulated circumscribed mass is noted between the uncinate process of the pancreas and the C loop of the duodenum which measures 2.7 x 2.0 cm (series 801, image 20). This mass demonstrates increased signal on T2 and diffusion weighted images, with possible mild heterogeneous enhancement. Several prominent surrounding lymph nodes are also seen. It has mass effect on the duodenum.Nonspecific small polypoid lesion in the stomach in the gastric body (series 1004, image 589). BONES, SOFT TISSUES: Several mildly enhancing lesions are noted within the lumbar spine and soft tissues. Soft tissue masses are also noted within the thecal sac, with resultant left sided neuroforaminal dilatation most pronounced at L4/L5 and L5/S1. OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See above discussion.BONES, SOFT TISSUES: See above discussion.OTHER: No significant abnormality noted.
1.Multilobulated, T2 hyperintense mass between the uncinate process and duodenal C-loop as described above. Differential considerations include neurofibroma/schwannoma given the patient's history of neurofibromatosis; (gastrinoma, cystic neuroendocrine tumor, GIST, are also in the differential). Follow-up with endoscopy or upper GI series is suggested to evaluate for duodenal obstruction. 2.Nonspecific small polypoid lesion in the stomach, for which dedicated follow-up can also be considered. 3.Soft tissue lesions in the thecal sac and several mildly enhancing lesions in the lumbar spine; these may also represent plexiform neurofibromas/schwannomas given their imaging appearance but dedicated MRI of the lumbar spine is recommended for further characterization. 