tailieunhanh - Ebook CT & MRI pathology – A pocket atlas: Part 2

Part 2 book “CT & MRI pathology – A pocket atlas” has contents: Gastrointestinal, benign prostatic hyperplasia, bladder cancer, prostate carcinoma, ovarian cyst, uterine leiomyoma, rectal cancer, hepatobiliary, miscellaneous, trauma, and other contnents. | PART VI Abdomen 279 GASTROINTESTINAL Carcinoid Description: Carcinoids are rare, slow-growing cancers which start in the lining of the gastrointestinal tract. Etiology: Unknown; however, genetic involvement is suspected. Epidemiology: Overall, cases per 100,000 population. They occur mostly in the appendix (50%) and small bowel (20%). The ileum is the most frequent site of involvement in the small bowel. Females and older adults are more commonly affected. Signs and Symptoms: The signs and symptoms may be vague. Patients may experience abdominal pain, bleeding, and bowel obstruction. Imaging Characteristics: Primary tumors may be small. Aggressive tumors >2 cm may have a necrotic center. May mimic a lymphoma. CT Appear as a bright wall mass with IV contrast. Thick fibrotic stranding radiates from the mass to adjacent bowel. Usually metastasize to the liver, are hypervascular, and best seen on the arterial phase. MRI T1-weighted signal is isointense to muscle. T1-weighted postgadolinium shows bright signal on delayed studies. T2-weighted signal may vary from isointense to hyperintense to muscle. Treatment: Surgery is the treatment of choice. Chemotherapy is helpful for metastatic spread. 280 Prognosis: Results are better if complete resection of the localized tumor is accomplished. FIGURE 1. Carcinoid. Pre- (A) and postcontrast (B) CTs of the abdomen show an enhancing, partially calcified, stellate mid-abdominal mesenteric mass with radiating bands of fibrosis and retraction of the surrounding small bowel, giving a classic “sunburst” appearance. FIGURE 2. Carcinoid. Contrast-enhanced CT (CECT) coronal multiplanar reconstruction (MPR) image shows similar findings as the axial images. In this image, multiple low-attenuation liver metastases can be seen. 281 Colorectal Cancer Description: Colorectal cancer (adenocarcinoma of the colon) is the most common malignant tumor affecting the gastrointestinal tract. Colorectal cancer often begins as a polyp .

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