Differential Diagnosis for Pancreatic Head and Body Findings

• Single most likely diagnosis
  • Pancreatic lobulation: This is the most likely diagnosis given that the focal hypodense area in the pancreatic body appears to be consistent with pancreatic lobulation on sagittal images. Pancreatic lobulation is a normal anatomical variant where the pancreatic tissue has a lobulated appearance.
• Other Likely diagnoses
  • Focal pancreatitis: Although less likely, the focal hypodense area could represent a mild or early form of pancreatitis. The normal size of the CBD makes a significant obstructive cause less likely, but pancreatitis can occur without obstruction.
  • Pancreatic cyst: A small, simple pancreatic cyst could also present as a focal hypodense area. However, the description of it appearing as pancreatic lobulation on sagittal images leans away from this diagnosis.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Pancreatic adenocarcinoma: Although the description does not strongly suggest malignancy, pancreatic cancer can present with subtle imaging findings, especially in early stages. It is crucial to consider this diagnosis to ensure timely evaluation and management.
  • Neuroendocrine tumor: Similar to pancreatic adenocarcinoma, a neuroendocrine tumor could present as a focal lesion in the pancreas. These tumors can be functional or non-functional and may have significant implications for patient management.
• Rare diagnoses
  • Solid pseudopapillary neoplasm (SPN): This is a rare tumor of the pancreas that tends to occur in younger women. It often presents as a well-circumscribed mass and can have variable imaging characteristics.
  • Lymphoma: Primary pancreatic lymphoma is rare and can present with a variety of imaging findings, including focal masses or diffuse enlargement of the pancreas.