Date : 00.00.00
Name of the Patient : Abc XyzK. Mlmn / F / 55 yrs.
Referred by : Dr. Abc Xyzorat.
Examination : M.R. Cholangiogram.
CLINICAL PROFILE :
C/O pain in the abdomen since 2 months.
The upper abdomen was scanned with 7 mm thick T1 Weighted and T2 Weighted axial images and 4 mm thick T1 Weighted and STIR axial images.
MR cholangiogram was also obtained.
There is seen an approximately 3.5 x 3.0 x 4.0 cms. sized well-marginated, hypointense mass lesion on the T1 Weighted images in the precaval region, in close relation to the head of the pancreas. This lesion appears heterogeneously hyperintense on the T2 Weighted and STIR images. Cystic/necrotic areas are noted within this region, posteriorly.
There is posterior displacement and mild compression of the inferior vena cava at the site of the lesion. The portal vein and the head of the pancreas are displaced slightly anteriorly. Slight extension of the lesion into the region of portahepatis is noted. The distal end of the common bile duct in the pancreatic head is well identified.
There is seen an approximately 3.0 cms diameter sized well-marginated, hypointense lesion on the T1 Weighted images in the right lobe of the liver, anteriorly and laterally, in close relation to the gall bladder fossa. This lesion appears relatively hypointense on the T2 Weighted images but is slightly hyperintense on the STIR images. No satellite lesions are noted.
There is no dilatation of the intrahepatic biliary radicles.
The gall bladder shows no intrinsic lesion. The body and tail of the pancreas are unremarkable.
Spleen, both kidneys and adrenal glands are unremarkable.
There is no free fluid in the abdomen.
The MRCP reveals a normal sized right and left hepatic ducts and common bile duct. No intrahepatic biliary radicle dilatation is noted. The pancreatic duct is not dilated.
1. An approximately 3.5 x 3.0 x 4.0 cms. sized mass lesion in the precaval region, in close relation to the head of the pancreas as described is not specific for a single etiology. The differential diagnosis would include :
a. An exophytic carcinoma of the head of the pancreas.
b. A lymphnodal mass, ? metastatic.
c. Less likely to represent an inflammatory pancreatic lesion.
2. An approximately 3.0 cms diameter sized mass lesion in the right lobe of the liver, anteriorly and laterally, in close relation to the gall bladder fossa is also not specific for a single etiology, but most likely represents a neoplasm.
3. The MR cholangiogram reveals normal biliary tree.