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Work up for abdominal pain and jaundice.
A 48×35 mm low enhancing mass is present at the pancreatic head and neck, accompanied by vascular encasement, peripancreatic fat stranding, and several small regional and mesenteric enlarged lymph nodes. Distal pancreatic atrophic changes and pancreatic and biliary duct dilatation are also observed.
Degenerative changes as osteophytosis are seen in the lumbar spine.
Grade I spondylolisthesis of L4 on L5 is present.