Male 60 years old Reason: Hypodense lesion in pancreas in immunosuppressed transplant patient, malignancy vs fatty infiltrate History: as above ABDOMEN:LIVER, BILIARY TRACT: Mild hepatic steatosis. No focal hepatic lesions. Hepatic and portal veins are patent. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Small T2 hyperintense lesion in the head of the pancreas measures 0.9 x 0.7 cm (image 12/series 601). Lesion shows no significant enhancement. The lesion is located adjacent to the pancreatic duct. There is suggestion of connection to the pancreatic duct. The lesion most likely represents a small side branch duct IPMN. There is no pancreatic atrophy. The remainder of the pancreatic duct is normal in caliber. There are few other small T2 hyperintense foci along the course of the pancreas which may also represent small side branch that IPMNs.ADRENAL GLANDS: Left adrenal is mildly hyperplastic. Right adrenal gland is unremarkable.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small infrarenal abdominal aortic aneurysm measures 3 cm (image 97 series 1101).No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Subcentimeter lesion in head of pancreas most likely represents a small IPMN. There are several other small foci in the body and tail of the pancreas which may also represent IPMNs. M.R.C.P. in 12 to 18 months is suggested to evaluate for size change.