The pancreas contains several focal lesion in the pancreatic head, body and tail. All 3 lesions enhance. The main pancreatic duct is not dilated.
There is intra and extrahepatic bile duct dilatation with the common bile duct with an abrupt calibre change at the level of the pancreatic head mass. No peripancreatic fluid collection or inflammation.
No focal liver lesion. The hepatic veins, portal veins are patent.
Kidneys, adrenal glands, spleen are normal. No free fluid in the upper abdomen.
Several pancreatic masses, concerning for a malignant process given the biliary obstruction. Lymphoma and metastases should be considered. Adenocarcinoma is rare in this age group, particularly multifocal and without pancreatic duct obstruction. Multifocal neuroendocrine tumour is a possibility but relative hypoenhancement would be atypical.