Pancreatic body and tail cystic lesion. Pt with documented pancreatic body tail mass that measured 3.2 X 2.9 cm on 8/14/15 MRCP. Had EUS 8/19/15,, lesion c/w serous cyst adenoma, CEA 7.8 and Amylase 95. Needs repeat imaging in 12-18 months if necessary. ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis within a normally distended gallbladder. Focal mild cystic thickening of the gallbladder fundus and the neck is unchanged dating back to 2012, likely focal adenomyomatosis.No choledocholithiasis or biliary ductal dilatation.The liver is normal in morphology, size, signal intensity and enhancement without a focal lesion.The vessels are patent.SPLEEN: The spleen is borderline enlarged measuring 15 cm in craniocaudal dimension.PANCREAS: In the distal pancreatic body/tail junction there is a 3.1 x 2.5 x 3.1 cm cystic lesion with a lobular contour and multiple internal cystic components in a cluster of grapes appearance. It previously measured 3.2 x 2.9 cm. There is no definite communication with the adjacent normal caliber main pancreatic duct. Postcontrast images demonstrate thin rim septal enhancement internally but no suspicious mural nodularity or soft tissue enhancement.Several punctate cystic foci with the largest measuring 8 mm in the pancreatic head, unchanged.Normal variant pancreaticobiliary ductal anatomy. Normal intrinsic T1-weighted signal intensity and postcontrast enhancement of the pancreas.ADRENAL GLANDS: Stable subcentimeter left adrenal lipid rich adenoma.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Tortuous abdominal aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Stable pancreatic distal body/tail cystic lesion with morphology most suggestive of a serous cystadenoma.2.Additional punctate cystic pancreatic foci without suspicious imaging characteristics may represent small sidebranch IPMNs.