63-year-old male with HCV cirrhosis and chronic pancreatic ductal dilation. HCC screening. ABDOMEN: Mild cardiomegaly and left ventricular wall thickening, partially visualized and similar to prior exam.LIVER, BILIARY TRACT: Nodular contour with several subcentimeter dark T2 signal foci, similar to prior. Scattered subcentimeter T2 hyperintense lesions are too small to characterize but most likely due to cysts, similar to prior study. No suspicious hepatic lesions. No biliary ductal dilation. Gallbladder is unremarkable.SPLEEN: Unchanged bright T2 lesions may represent hemangiomas versus cysts.PANCREAS: Again seen is ductal dilation in the distal body and tail with associated side branch irregularity, compatible with chronic pancreatitis/obstruction. The degree of dilation has slightly progressed since prior study. Again seen is an abrupt truncation of the duct at the body. There is an apparent round lesion in the pancreatic body at the transition point measuring up to 2 x 3 cm (series 16/140) which demonstrates T1 and T2 hypointensity with relative hypoenhancement. The lesion also demonstrates restricted diffusion and increasing enhancement on delayed phase images. The findings are suspicious for a pancreatic neoplasm. There is focal occlusion of the splenic vein traversing posterior to this lesion.Restricted diffusion in the pancreatic tail is most likely related to chronic pancreatitis, similar to prior study.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: L4 vertebral body hemangioma.OTHER: No significant abnormality noted.
1.Pancreatic ductal dilation has slightly progressed with abrupt truncation due to a 3.0cm lesion. Differential considerations include neuroendocrine neoplasm or adenocarcinoma.2. Correlation with endoscopic sampling is recommended.3.No suspicious hepatic lesions.