0:01

This is another case here with the cystic

0:02

lesion in the pancreatic parenchyma,

0:04

which was detected on outside CT, and we are

0:07

trying to reassess and reevaluate this

0:09

lesion to better characterize it on MR.

0:12

We see a lesion in the pancreatic tail, which is

0:14

well-defined, lined by a thick capsule, which is

0:17

T2-hypointense and demonstrates multiple tiny cystic

0:22

lesions inside separated by thin septations here.

0:25

If we pay attention, we can see thin septations.

0:28

And this lesion classically looks

0:29

like honeycomb in appearance.

0:32

There is no central scar here; maybe it is

0:34

there, but difficult to predict on MR, at least.

0:37

Calcification can be seen better on CT.

0:40

And then if we see carefully here,

0:41

along with the tail, the duct is not

0:44

communicating with this lesion anywhere.

0:47

Duct also looks normal in appearance and size.

0:50

And as we move forward in the pancreatic

0:53

head region, we see some macrocystic

0:56

multiloculated cystic lesions.

0:58

Those are situated in a clump together, and that

1:02

is classical with an IPMN because it is looking

1:05

like a bunch of grape in the pancreatic head.

1:07

And side branch IPMNs, though more common in the

1:11

males, but can be seen in both males and females.

1:15

This is the case of female, elderly female

1:17

presenting with pancreatic tail lesion.

1:19

And if we see this lesion in the coronal,

1:22

we can find a similar kind of appearance.

1:24

The duct is actually

1:25

terminating near this capsule.

1:27

It's not communicating with the lesion.

1:29

We can find a similar honeycombed

1:31

appearance with multiple tiny

1:33

cystic lesions inside separated by thin

1:35

septations, and that lesion inside the

1:38

pancreatic head is looking very different.

1:41

They are multiple cysts.

1:42

They are bigger in size.

1:43

The septations are thick, and there is

1:45

possible communication with the main duct.

1:48

So overall, there is no confusion here

1:49

because this lesion looks like IPMN,

1:51

and that lesion is looking like almost

1:53

serious tumor because it is honeycombed.

1:56

Sometimes honeycombed lesions can be bigger in

1:59

size, and they can mimic IPMN, and demonstration

2:02

of communication with the main duct is the key

2:05

to make diagnosis.