– 11 year old, MN DLH presented with lethargy and v/d

– had a dental procedure a couple of weeks ago in which pre-op bloodwork was wnl

– bloodwork now shows moderate anemia, neutropenia and severely elevated lipase (fPLI and viral testing not done)

– a mass that appears to be attached to the right pancreatic limb was detected on ultrasound with an irregular cystic region

– FNA’s of the cystic fluid and the mass are pending

– LN’s in the region were slightly enlarged and there is some mild hyperechoic fat around the region

– 11 year old, MN DLH presented with lethargy and v/d

– had a dental procedure a couple of weeks ago in which pre-op bloodwork was wnl

– bloodwork now shows moderate anemia, neutropenia and severely elevated lipase (fPLI and viral testing not done)

– a mass that appears to be attached to the right pancreatic limb was detected on ultrasound with an irregular cystic region

– FNA’s of the cystic fluid and the mass are pending

– LN’s in the region were slightly enlarged and there is some mild hyperechoic fat around the region

So –  chronic active pancreatitis with pseudocyst formation or abscess (fluid was not purulent), neoplasia – what do you think?