Pancreatic cancer -- follow-up. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Infusion port in right anterior chest wall with tip of catheter in the distal superior vena cava unchanged..ABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration liver again identified -- this obscures the ability to see lesions in the liver and if concern for metastatic disease in liver exists, ultrasound or MRI would be recommended. Pneumobilia seen from prior choledocho jejunostomy..SPLEEN: No significant abnormality noted.PANCREAS: Prior surgery status post Whipple procedure. Remaining pancreas appears normal and unchanged..ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Again noted are multiple small mesenteric lymph nodes along the root of the mesentery. The largest of these measures 1.0 x 2.3 cm (series 5 come image 108) with multiple smaller ones lower inferiorly. These are all unchanged and of uncertain significance. No new lesions are identified. The mild soft tissue cuffing along the posterior SMA remains unchanged with mild narrowing of the origin of the SMA better seen on prior exam and narrowing is less prominent on current examination. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Post hysterectomy without other abnormality..BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Status post Whipple procedure with stable exam and no significant change since prior examination. 2. Small lymph nodes at the root of mesentery appear unchanged and are of uncertain significance. 3. Diffuse fatty infiltration the liver -- this can obscure the presence of liver lesions and if concern exists for liver metastases, ultrasound or MR would be recommended.