History of pancreatic cyst. 03/24/2015 EGD/EUS FNA Non-diagnostic. EGD/EUS on 6/19/2014 with a 3 x 2 cm pancreatic tail cyst without worrisome sonographic findings except for size (no mural nodules no wall thickening). Cytology negative, cyst fluid CEA low 3.4, fluid amylase high 444,400. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Bilobed/septated lesion in the distal pancreatic body measures 1.8 x 1.2 cm (series 5/53), compared to 1.8 x 0.6 cm previously. Enhancing thin-walled septations are present. Demonstrates no solid internal or mural enhancement. The remainder of the pancreas is unremarkable. It does not appear to communicate with the main pancreatic duct which is located anteroinferior to the lesion. The 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: No significant abnormality noted.OTHER: No significant abnormality noted.
Interval increase in size of the bilobed/septated pancreatic tail cystic lesion. Mild thin-walled enhancement of the septations. No internal mural nodularity or solid enhancement. The appearance is similar to the 2013 MRI, prior to FNA. The lesion does not distinctly appear to communicate with the normal caliber main pancreatic duct. Given the patient's age and the interval increase in size a cystic neoplasm, specifically a mucinous neoplasm should also be considered in addition to an IPMN.