Limits...
The association of anisakiasis in the ascending colon with sigmoid colon cancer: CT colonography findings.

Yoo HJ, Kim SH, Lee JM, Kim MA, Han JK, Choi BI - Korean J Radiol (2008)

Bottom Line: Only one case of this type has been reported to date.A total colectomy was performed and the diagnosis of synchronous sigmoid colon cancer and anisakiasis of the ascending colon was confirmed.This case is the first reported visualization of synchronous colon cancer and colonic anisakiasis on a CTC.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.

ABSTRACT
The association of anisakiasis of the colon with colon cancer is rare and difficult to diagnose. Only one case of this type has been reported to date. In this study, we report a case of synchronous colon cancer and colonic anisakiasis. A 50-year-old woman was admitted for abdominal pain, and a volume-rendered surface-shaded image of CT colonography (CTC) revealed a concentric narrowing in the sigmoid colon and a segmental fold thickening in the ascending colon. A total colectomy was performed and the diagnosis of synchronous sigmoid colon cancer and anisakiasis of the ascending colon was confirmed. This case is the first reported visualization of synchronous colon cancer and colonic anisakiasis on a CTC.

Show MeSH

Related in: MedlinePlus

Anisakiasis of ascending colon in association with sigmoid colon cancer.A, B. Coronal multiplanar reconstruction images of CT colonography demonstrated concentric and enhancing wall thickening with luminal narrowing in sigmoid colon (arrow in A) and low attenuating wall thickening with pericolic infiltration in ascending colon (arrows in B).C. Volume rendered surface-shaded image on CT colonography revealed apple-core shaped, concentric narrowing in sigmoid colon (arrow). In ascending colon, segmental fold thickening with thumb print-like appearance was seen (arrowheads).D. Virtual endoscopic image of sigmoid colon revealed concentric mass (arrows).E. Irregular fold thickening and mild luminal narrowing was identified in virtual endoscopic image of ascending colon.F. Gross pathologic specimen revealed ulceroinfiltrative mass (arrows) in sigmoid colon and another ulcerative mass (arrowheads) in ascending colon. The adjacent folds (*) around ascending colonic mass were edematous.G. Histological examination (original magnification ×5, Hematoxylin & Eosin staining) revealed heavy infiltration by eosinophils. Several parasite worms (arrows) were found within edematous submucosal layer.H. Microscopic photograph (original magnification, ×100) of cross-section through intestinal region of nematode. Note external cuticle (C) of overlying muscle layer (M), two Y-shaped lateral epidermal cords (EC), and digestive tract (DT) with single layer of columnar epithelial cells.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2627183&req=5

Figure 1: Anisakiasis of ascending colon in association with sigmoid colon cancer.A, B. Coronal multiplanar reconstruction images of CT colonography demonstrated concentric and enhancing wall thickening with luminal narrowing in sigmoid colon (arrow in A) and low attenuating wall thickening with pericolic infiltration in ascending colon (arrows in B).C. Volume rendered surface-shaded image on CT colonography revealed apple-core shaped, concentric narrowing in sigmoid colon (arrow). In ascending colon, segmental fold thickening with thumb print-like appearance was seen (arrowheads).D. Virtual endoscopic image of sigmoid colon revealed concentric mass (arrows).E. Irregular fold thickening and mild luminal narrowing was identified in virtual endoscopic image of ascending colon.F. Gross pathologic specimen revealed ulceroinfiltrative mass (arrows) in sigmoid colon and another ulcerative mass (arrowheads) in ascending colon. The adjacent folds (*) around ascending colonic mass were edematous.G. Histological examination (original magnification ×5, Hematoxylin & Eosin staining) revealed heavy infiltration by eosinophils. Several parasite worms (arrows) were found within edematous submucosal layer.H. Microscopic photograph (original magnification, ×100) of cross-section through intestinal region of nematode. Note external cuticle (C) of overlying muscle layer (M), two Y-shaped lateral epidermal cords (EC), and digestive tract (DT) with single layer of columnar epithelial cells.

Mentions: A 50-year-old woman was admitted to our hospital complaining of severe left lower quadrant pain which began 10 days prior to admission. The patient experienced one episode of hematochezia and a change in stool caliber, both of which first began two months before. The patient also had a history of hypertension and an appendectomy. A physical examination identified tenderness in the right lower quadrant of the abdomen. The laboratory findings, upon initial admission, showed a slight decrease of hemoglobin (11.5 g/dL) and hematocrit (33.1%) level, as well as a marked elevation of the eosinophil count (17.1%). The serum level of the carcinoembryonic antigen (CEA) was within the normal range. An abdominal plain radiography revealed a distension of the bowel loops, which was a sign of ileus. A coronal multiplanar reconstruction image of a CTC demonstrated a concentric and enhancing wall thickening, along with luminal narrowing in the sigmoid colon (Fig. 1A), and a low attenuating wall thickening with pericolic infiltration in the ascending colon (Fig. 1B). A volume-rendered surface-shaded image of a CTC showed an apple-core shaped, concentric narrowing in the sigmoid colon (Fig. 1C). In addition, a segmental fold thickening with a thumbprint-like appearance (Fig. 1C) was seen in the ascending colon. A virtual endoscopic image of the sigmoid colon revealed a concentric mass (Fig. 1D), which led to a narrowing of the colon. An irregular fold thickening and mild luminal narrowing (Fig. 1E) was also observed via a virtual endoscopic image of the ascending colon. A colonoscopy was performed; however, due to the severe obstruction of the sigmoid colon by the concentric mass, the scope could not traverse the mass and hence, could not attain the ascending colon.


The association of anisakiasis in the ascending colon with sigmoid colon cancer: CT colonography findings.

Yoo HJ, Kim SH, Lee JM, Kim MA, Han JK, Choi BI - Korean J Radiol (2008)

Anisakiasis of ascending colon in association with sigmoid colon cancer.A, B. Coronal multiplanar reconstruction images of CT colonography demonstrated concentric and enhancing wall thickening with luminal narrowing in sigmoid colon (arrow in A) and low attenuating wall thickening with pericolic infiltration in ascending colon (arrows in B).C. Volume rendered surface-shaded image on CT colonography revealed apple-core shaped, concentric narrowing in sigmoid colon (arrow). In ascending colon, segmental fold thickening with thumb print-like appearance was seen (arrowheads).D. Virtual endoscopic image of sigmoid colon revealed concentric mass (arrows).E. Irregular fold thickening and mild luminal narrowing was identified in virtual endoscopic image of ascending colon.F. Gross pathologic specimen revealed ulceroinfiltrative mass (arrows) in sigmoid colon and another ulcerative mass (arrowheads) in ascending colon. The adjacent folds (*) around ascending colonic mass were edematous.G. Histological examination (original magnification ×5, Hematoxylin & Eosin staining) revealed heavy infiltration by eosinophils. Several parasite worms (arrows) were found within edematous submucosal layer.H. Microscopic photograph (original magnification, ×100) of cross-section through intestinal region of nematode. Note external cuticle (C) of overlying muscle layer (M), two Y-shaped lateral epidermal cords (EC), and digestive tract (DT) with single layer of columnar epithelial cells.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627183&req=5

Figure 1: Anisakiasis of ascending colon in association with sigmoid colon cancer.A, B. Coronal multiplanar reconstruction images of CT colonography demonstrated concentric and enhancing wall thickening with luminal narrowing in sigmoid colon (arrow in A) and low attenuating wall thickening with pericolic infiltration in ascending colon (arrows in B).C. Volume rendered surface-shaded image on CT colonography revealed apple-core shaped, concentric narrowing in sigmoid colon (arrow). In ascending colon, segmental fold thickening with thumb print-like appearance was seen (arrowheads).D. Virtual endoscopic image of sigmoid colon revealed concentric mass (arrows).E. Irregular fold thickening and mild luminal narrowing was identified in virtual endoscopic image of ascending colon.F. Gross pathologic specimen revealed ulceroinfiltrative mass (arrows) in sigmoid colon and another ulcerative mass (arrowheads) in ascending colon. The adjacent folds (*) around ascending colonic mass were edematous.G. Histological examination (original magnification ×5, Hematoxylin & Eosin staining) revealed heavy infiltration by eosinophils. Several parasite worms (arrows) were found within edematous submucosal layer.H. Microscopic photograph (original magnification, ×100) of cross-section through intestinal region of nematode. Note external cuticle (C) of overlying muscle layer (M), two Y-shaped lateral epidermal cords (EC), and digestive tract (DT) with single layer of columnar epithelial cells.
Mentions: A 50-year-old woman was admitted to our hospital complaining of severe left lower quadrant pain which began 10 days prior to admission. The patient experienced one episode of hematochezia and a change in stool caliber, both of which first began two months before. The patient also had a history of hypertension and an appendectomy. A physical examination identified tenderness in the right lower quadrant of the abdomen. The laboratory findings, upon initial admission, showed a slight decrease of hemoglobin (11.5 g/dL) and hematocrit (33.1%) level, as well as a marked elevation of the eosinophil count (17.1%). The serum level of the carcinoembryonic antigen (CEA) was within the normal range. An abdominal plain radiography revealed a distension of the bowel loops, which was a sign of ileus. A coronal multiplanar reconstruction image of a CTC demonstrated a concentric and enhancing wall thickening, along with luminal narrowing in the sigmoid colon (Fig. 1A), and a low attenuating wall thickening with pericolic infiltration in the ascending colon (Fig. 1B). A volume-rendered surface-shaded image of a CTC showed an apple-core shaped, concentric narrowing in the sigmoid colon (Fig. 1C). In addition, a segmental fold thickening with a thumbprint-like appearance (Fig. 1C) was seen in the ascending colon. A virtual endoscopic image of the sigmoid colon revealed a concentric mass (Fig. 1D), which led to a narrowing of the colon. An irregular fold thickening and mild luminal narrowing (Fig. 1E) was also observed via a virtual endoscopic image of the ascending colon. A colonoscopy was performed; however, due to the severe obstruction of the sigmoid colon by the concentric mass, the scope could not traverse the mass and hence, could not attain the ascending colon.

Bottom Line: Only one case of this type has been reported to date.A total colectomy was performed and the diagnosis of synchronous sigmoid colon cancer and anisakiasis of the ascending colon was confirmed.This case is the first reported visualization of synchronous colon cancer and colonic anisakiasis on a CTC.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.

ABSTRACT
The association of anisakiasis of the colon with colon cancer is rare and difficult to diagnose. Only one case of this type has been reported to date. In this study, we report a case of synchronous colon cancer and colonic anisakiasis. A 50-year-old woman was admitted for abdominal pain, and a volume-rendered surface-shaded image of CT colonography (CTC) revealed a concentric narrowing in the sigmoid colon and a segmental fold thickening in the ascending colon. A total colectomy was performed and the diagnosis of synchronous sigmoid colon cancer and anisakiasis of the ascending colon was confirmed. This case is the first reported visualization of synchronous colon cancer and colonic anisakiasis on a CTC.

Show MeSH
Related in: MedlinePlus