Pancreatic cystic lesion without worrisome features. Patient < 80. Cyst > 2.5 cm.

Please select from the following options:

The lesion was smaller, has newly grown to 2.5 cm or larger.

New lesion. Most likely serous cystadenoma.

New or pre-existing lesion with low risk features.

New or pre-existing lesion with high risk features.

New lesion. Will recommend endoscopic ultrasound/FNA instead of follow-up imaging.

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Notes:

Low risk features: No peripheral calcification. No mural nodule. No wall thickening. Normal caliber MPD. If surgery is contemplated for low risk cysts, endoscopic ultrasound/FNA is strongly advised before the surgery.
High risk features: Peripheral calcification. Mural nodules. Wall thickening. MPD>=7 mm in diameter.

Radiologists have the option to recommend endoscopic ultrasound/FNA instead of follow-up imaging in this situation. The protocols at many medical centers require immediate endoscopic ultrasound/FNA for lesion of this size.