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Annular Apple Core Colonic Lesion: a Differential Diagnosis.

Moser, III RPMI - MedPix (2013)

View Article: MedPix Image - MedPix Case

Affiliation: Walter Reed Army Medical Center

ABSTRACT

Diagnosis: Annular Apple Core Colonic Lesion: a Differential Diagnosis.

History: A 56-year-old male with a three-month history of ill-defined lower abdominal pain and a 10 pound weight loss.

Findings: An axial CT image through the pelvis following the administration of oral contrast shows excellent contrast-distention of the descending colon and proximal sigmoid colon with an apparent focal area of circumferential colonic wall thickening involving an approximately 4 cm segment of sigmoid colon (in the left hemipelvis adjacent to the bladder). Overhead and spot images from a gastrograffin enema show, within the sigmoid colon, a classic “apple core” lesion: a relatively short, sharply defined region of annular, constricting colonic narrowing with overhanging margins, ulcerated mucosa, and an eccentric and irregular lumen.

Ddx: Biopsy-proven adenocarcinoma of the sigmoid colon. Please see the accompanying factoid for a discussion of the differential diagnosis.

Dxhow: Resection and histology

Exam: There is minimal diffuse abdominal tenderness to deep palpation without palpable masses, rebound tenderness, or guarding. The physical examination is otherwise noncontributory. The complete blood count is remarkable for a hematocrit of 33.

No MeSH data available.


Here is a real "apple core" for correlation.
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MPX1661_synpic12135: Here is a real "apple core" for correlation.


Annular Apple Core Colonic Lesion: a Differential Diagnosis.

Moser, III RPMI - MedPix (2013)

Here is a real "apple core" for correlation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1661&req=5

MPX1661_synpic12135: Here is a real "apple core" for correlation.

View Article: MedPix Image - MedPix Case

Affiliation: Walter Reed Army Medical Center

ABSTRACT

Diagnosis: Annular Apple Core Colonic Lesion: a Differential Diagnosis.

History: A 56-year-old male with a three-month history of ill-defined lower abdominal pain and a 10 pound weight loss.

Findings: An axial CT image through the pelvis following the administration of oral contrast shows excellent contrast-distention of the descending colon and proximal sigmoid colon with an apparent focal area of circumferential colonic wall thickening involving an approximately 4 cm segment of sigmoid colon (in the left hemipelvis adjacent to the bladder). Overhead and spot images from a gastrograffin enema show, within the sigmoid colon, a classic “apple core” lesion: a relatively short, sharply defined region of annular, constricting colonic narrowing with overhanging margins, ulcerated mucosa, and an eccentric and irregular lumen.

Ddx: Biopsy-proven adenocarcinoma of the sigmoid colon. Please see the accompanying factoid for a discussion of the differential diagnosis.

Dxhow: Resection and histology

Exam: There is minimal diffuse abdominal tenderness to deep palpation without palpable masses, rebound tenderness, or guarding. The physical examination is otherwise noncontributory. The complete blood count is remarkable for a hematocrit of 33.

No MeSH data available.