75-year-old female with pancreatic ductal dilatation and history of pancreatic cancer. Patient is status post Whipple in 2006. Most recent surveillance imaging in May 20, 2016 showed dilated pancreatic duct. EUS on 7/11/2016 with a dilated pancreatic duct and some changes in the residual pancreas of lobularity, no mass. Follow-up 3 month MRCP exam. ABDOMEN:LIVER, BILIARY TRACT: Status post hepaticojejunostomy. Minimal left biliary ductal dilatation. There is a subcentimeter nonenhancing T1 hypointense focus in the left hepatic lobe (axial series 11 image 136) that is too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: Status post Whipple procedure. There is a hypoenhancing lesion in the distal-most aspect of the residual pancreatic body (axial series 11 image 130) measuring 1.7 x 1.2 cm with upstream ductal dilatation of 4.5 mm. This lesion also demonstrates increased signal intensity on diffusion-weighted imaging (axial series 4 image 98).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: Broad-based supraumbilical ventral hernia containing a segment of transverse colon and omental fat (axial series 8 image 34). A more inferior ventral hernia contains a loop of small bowel (axial series 8 image 47). No bowel obstruction. No ascites.Incidental note is made of an intramuscular lipoma of the right lateral abdominal wall (axial series 8 image 28).OTHER: No significant abnormality noted.
1.Obstructing mass of the proximal-most aspect of the residual pancreatic body with associated upstream ductal dilatation.2.Too small to characterize nonenhancing T1 hypointense lesion of the left hepatic lobe. A larger hypodense lesion in this location was noted on the 2006 CT exam. This could be a residual small cyst, however attention on follow-up imaging is recommended.