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Dr. David
Dr. David, Board Certified Physician
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Following are the results of an MRCP of my pancreas done on

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Following are the results of an MRCP of my pancreas done on October 08, 2014. Six months later I had an ultrasound which showed no change. On November 14 2015 I had another MRCP but I have not received the results from my gastroenterologist. I hope this is good news, not having heard from my doctor. The technique used for the 2014 MRI was: Coronal and axial HASTE, axial GRE T1, in and out of phase, 3D t@ SPACE MRCP images acquired coronally and viewed in a radial orientation every 10 degrees. Three @D HASTE MIP images of the biliary tree were also obtained. In addition, pre and post gadolinium axial VIBE images were also obtained. The results were: No significant pancreatic ductal or biliary dilation identified. There are some cystic changes noted in the pancreatic body/tail junction with two adjacent cysts without definite communication of the pancreatic duct. The superior most aspect of the conglomerate cystic structure does appear in close proximity to the pancreatic duct and the conglomerate cystic structure measures 1.4X1.6X1.6 cm. No definite enhancement of the pancreatic structures. Radiologists Impressions: Cystic changes in the pancreas as described above at the pancreatic body/tail junction. Cyst pr other pancreatitis cystic lesion including side branch IPMN is possible. given the size of the HTE lesion, MRI followup in one year is recommended. I have also developed Type 2 diabetes over the last 4 months. I have been somewhat overweight before this, with significant belly fat. How con concerned should I be? Should I ask for an endoscopic ultrasound and examination of the fluid in the cysts for cancerous or per-cancerous cells? Is this condition likely to develop into pancreatic cancer? How often should I have a follow up?
Submitted: 11 months ago.
Category: Medical
Expert:  Dr Basu replied 11 months ago.

Hi there,
This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.

As per current guidelines the size of the cyst is less than 2 cm --indicating very low risk of pancreatic cancer.

The pancratic duct is not dilated --another good point.

Hence, there is no need for concern.

CT or MRI repeat after a year is adequate to monitor for any changes.

EUS or biopsy not required.
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Expert:  Dr. David replied 11 months ago.

This is Dr. David

I am a cancer doctor.

many, if not most, branch duct IPMNs are harmless and the risks associated with surgery may outweigh the benefits of resecting small branch duct IPMNs

if you are asymptomatic from this lesion and it is smaller than 3cm and there is no ductal dilitation, then you don't have to undergo surgery to have it removed.

unfortunately, some resected branch duct IPMNs that are less than 3 cm have been found to have cancer, so the guidelines do not perfectly distinguish patients with benign or malignant disease.

biopsy or aspiration doesn't always help get information.

if there are worrisome signs on the most recent MRI scans from Nov, then surgery should be considered.

you should ask your doctor for a copy of the MRI scan report from November.

I would be happy to review it with you

let me know if you have other questions.

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