History of BRCA2 mutation and 2 first degree relatives with history of pancreatic cancer. Evaluate for tumor. ABDOMEN:Extensive respiratory motion artifact limits evaluation, particularly of the postcontrast images.LIVER, BILIARY TRACT: The liver is normal in morphology and the background parenchyma has normal signal characteristics. There are multiple T2 bright cystic lesions without definite enhancement. One cyst in the subcapsular right lobe of has intrinsic high T1 signal ingesting hemorrhage or proteinaceous material.There are multiple round hepatic lesions with mildly increased T2 signal and restricted diffusion measuring up to 6 mm in diameter (series 3 image 13, 17, 21). It is unclear if these lesions enhance due to their small size and extensive motion artifact on the postcontrast images, however given the clinical history and appearance, these are highly suspicious for metastases.SPLEEN: No significant abnormality noted.PANCREAS: No pancreatic mass is evident within the limits of the exam. There is minimal diffuse fatty atrophy of the gland. The main pancreatic duct is nondilated.ADRENAL GLANDS: Slight nodularity of the left adrenal gland.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No upper abdominal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Numerous foci of increased T2 signal throughout the visualized thoracolumbar spine compatible with metastases.OTHER: Partially visualized large left pleural effusion with associated left lung atelectasis. There are numerous pulmonary nodules in the right lower lobe which are not significantly changed from prior accounting for differences in technique and compatible with metastases. There is associated pleural thickening.
1.Multiple round subcentimeter lesions within the liver as described. Evaluation is somewhat limited due to the small size and extensive respiratory motion artifact, but the appearance is highly suspicious for metastases.2.No evidence of a primary pancreatic mass within the limits of this severely motion degraded exam. 3.Partially visualized large left pleural effusion and multiple right lung metastatic lesions better evaluated on recent CT scan. Additionally there are numerous foci of signal abnormality in the thoracolumbar spine compatible with metastases.