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Fig. 17. —Pancreatic ductal carcinoma simulates intraductal papillary mucinous neoplasm in this 57-year-old man with abdominal distention and jaundice. CT scan reveals marked dilatation of main pancreatic duct (arrow). This dilatation with parenchymal atrophy could simulate main duct intraductal papillary mucinous neoplasm. However, there is dilatation of biliary tree as well. Biopsy of low-attenuation area within uncinate process (not shown) revealed pancreatic ductal carcinoma.