History of multiple cystic lesions throughout the pancreas thought to be IPMNs, follow-up. ABDOMEN:LIVER, BILIARY TRACT: Decreased hepatic parenchymal signal on out of phase images is compatible with diffuse hepatic steatosis. No suspicious focal hepatic lesions are identified. Again seen is a right portal venous branch thrombosis with multiple reconstituted collaterals that extend adjacent to the left portal vein. The main portal vein is patent, however, the portal splenic confluence is narrowed, similar to prior exam. There is no biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Innumerable cystic lesions are seen throughout an atrophic pancreas, similar to prior exam. Some of these lesions appear to connect to the pancreatic duct, most suggestive of IPMNs. No significant enhancing nodularity or diffusion restriction within these cysts to indicate malignancy. The reference pancreatic tail lesion is 1.6 x 1.3 cm (series 6, image 48), unchanged. The pancreatic duct is normal in caliber.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: The previously described right sacral insufficiency fracture is not included in the field-of-view.OTHER: Right lower lobe pulmonary nodularity, similar to prior.
Innumerable pancreatic cystic lesions most suggestive of IPMNs are not significantly changed. No specific evidence of malignancy.