64-year-old female patient with chronic generalized abdominal pain. Elevated alkaline phosphatase. LIVER: The liver measures 12.7 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: Near the pancreatic head/body junction, there is a 1.3 x 1.0 cm gently lobulated hypoechoic focus which does not demonstrate definite increased vascularity. This could correlate to a hypodense area on prior CT (axial image 98). There is no significant pancreatic ductal dilatation.RIGHT KIDNEY: The right kidney measures 11.3 cm in length. No evidence of hydronephrosis. There is a 0.1 x 1.2 x 0 cm septated cystic lesion within the right lower pole.OTHER: The left kidney measures 10.7 cm in length. No evidence of hydronephrosis.The spleen measures 8.0 cm in length.
1. Hypoechoic focus near the pancreatic head/body junction which could correlate to a hypodense region when compared to prior CT, and may represent a nonspecific cystic pancreatic neoplasm. Given the presence of an adjacent metal clip on the CT which could obscure a lesion on MRI, follow-up is recommended with ultrasound.2. Minimally complex right renal cyst.