Reason: 84 F w 17mm lesion in liver. Please also perform MRCP, family history of pancreatic carcinoma ABDOMEN:LIVER, BILIARY TRACT: Large heterogenous enhancing T1 dark, T2 bright segment 7 lesion, measurement as below. There is also mildly T2 bright lesion in segment 6, suspicious for metastasis. Scattered T2 hyperintense lesions compatible with cysts. There is intrahepatic and extrahepatic biliary ductal dilatation with common bile duct measuring up to 12 mm with abrupt cut off at the pancreatic head mass.SPLEEN: No significant abnormality noted.PANCREAS: Large mass, presumably arising from the pancreatic head, measurement as below. There is small fluid collection adjacent to this mass and enlarged peripancreatic lymph nodes. SMV is not well seen and may be occluded from this mass. There is soft tissue infiltration around SMA, suspicious for cancer spread. Distal pancreas is not well seen, likely atrophied. Pancreatic duct is not well visualized. This is suspicious for adenocarcinoma but EUS may be more definitive if indicated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral T2 hyperintense lesions, compatible with cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large abdominal ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Significantly elevated left hemidiaphragm with abdominal contents having cardiomediastinal shift to the right. INDEX LESION MEASUREMENTS (Current exam date/time: 12/28/2016 12:55:29)SEGMENT 7 HEPATIC LESION: 4.2 x 4.0 cm (Image 24, Series 8).PANCREATIC MASS: 5.6 x 6.1 cm (Image 330, Series 12).
1.Large mass presumably arising from the head of the pancreas as described above with metastatic lesions in the liver. CT chest is recommended for complete staging. 2.Significantly elevated left hemidiaphragm with abdominal contents causing cardiomediastinal shift to the right. 3.Findings were text paged to Dr. Bianca Chang.