Male 71 years old with NASH cirrhosis. IPMN and HCC screening. ABDOMEN:LIVER, BILIARY TRACT: Nodular liver contour, widening of the fissures and left lobe hypertrophy are consistent with cirrhosis. There is trace perihepatic ascites. No focal hepatic lesion.Improved but small residual nonocclusive superior mesenteric vein thrombosis. The portal vein is patent.Cholelithiasis. No intra or extrahepatic biliary ductal dilatation.SPLEEN: Splenomegaly and subcentimeter splenic cyst. Splenic varices and splenorenal shunting are redemonstrated.PANCREAS: There are two dominant multilobulated cystic lesions extending exophytically from the pancreatic head measuring 3.2 x 2.7 cm (series 5, image 36 and) and 1.7 x 1.6 cm (series 5, image 30). Additional, much smaller cystic foci are also seen. The main pancreatic duct appears normal in size.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal sinus and parenchymal cysts. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is mild thickening of the hepatic flexure suggestive of portal colopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Cirrhotic liver morphology with splenic varices and splenorenal shunting. No focal liver lesion.2.Improved nonocclusive superior mesenteric vein thrombosis.3.Thickening of the hepatic flexure suggestive of portal colopathy.4.Interval increase in size of cystic pancreatic head lesions. Based on size criteria, cyst aspiration should be considered for the 3.2 cm cyst.