How to approach and what are differentials to consider in this pancreatic lesion?
The features are those of a large pancreatic head cystic mass with no appreciable solid components, septation, or calcifications. The worrisome features for this finding would be the size and the dilated proximal pancreatic duct, MRI is recommended in this case. Differentials to consider would be a large IPMN or, less likely, a cystadenoma.
In the region of the pancreatic head, is a 22 x 42 mm tubular low-density structure which parallels the CBD and appears to have a claw of pancreatic tissue surrounding it. The lesion appears contiguous with the pancreatic duct and the proximal pancreatic duct is dilated (7.5 mm). The CBD is not distended. No peripancreatic lymphadenopathy. The solid viscera are otherwise unremarkable.