Abnormalities on computed tomography of the pancreas

A 35 year old man described 16 kg weight loss over the past six months, low mood, and poor appetite. He was concerned that he might have cancer. He reported that he smoked 10 cigarettes per day. He had been a carrier of hepatitis B virus for 10 years, and had been taking entecavir for three years although not consistently. Before the age of 28, he drank 500 ml of high concentration spirits daily until an episode of acute pancreatitis five years ago, and had not drunk alcohol since. Physical examination revealed mild abdominal tenderness. In laboratory tests, serum lipase was 65 U/L (normal level 60 U/L), aspartate amino transferase was 380 U/L (normal range 0-40 U/L), amino alanine transferase was 210 U/L (0-40 U/L), and fasting blood glucose was 4.72 mmol/L (3.82-6.11 mmol/L). …