TY - JOUR
T1 - Small bowel adenocarcinoma in Crohn disease
T2 - CT-enterography features with pathological correlation
AU - Soyer, Philippe
AU - Hristova, Lora
AU - Boudghène, Frank
AU - Hoeffel, Christine
AU - Dray, Xavier
AU - Laurent, Valérie
AU - Fishman, Elliot K.
AU - Boudiaf, Mourad
PY - 2012/6
Y1 - 2012/6
N2 - Purpose: The aim of this study was to analyze the clinical, pathological, and CT-enterography findings of small bowel adenocarcinomas in Crohn disease patients. Materials and methods: Clinical, histopathological, and imaging findings were retrospectively evaluated in seven Crohn disease patients with small bowel adenocarcinoma. CT-enterography examinations were reviewed for morphologic features and location of tumor, presence of stratification, luminal stenosis, proximal dilatation, adjacent lymph nodes, and correlated with findings at histological examination. Results: The tumor was located in the terminal (n = 6)or distal (n = 1) ileum. On CT-enterography, the tumor was visible in five patients, whereas two patients had no visible tumor. Four different patterns were individualized including small bowel mass (n = 2), long stenosis with heterogeneous submucosal layer (n = 2), short and severe stenosis with proximal small bowel dilatation (n = 2), and sacculated small bowel loop with irregular and asymmetric circumferential thickening (n = 1). Stratification, fat stranding, and comb sign were present in two, two, and one patients, respectively. Conclusion: Identification of a mass being clearly visible suggests strongly the presence of small bowel adenocarcinoma in Crohn disease patients but adenocarcinoma may be completely indistinguishable from benign fibrotic or acute inflammatory stricture. Knowledge of these findings is critical to help suggest the diagnosis of this rare but severe complication of Crohn disease.
AB - Purpose: The aim of this study was to analyze the clinical, pathological, and CT-enterography findings of small bowel adenocarcinomas in Crohn disease patients. Materials and methods: Clinical, histopathological, and imaging findings were retrospectively evaluated in seven Crohn disease patients with small bowel adenocarcinoma. CT-enterography examinations were reviewed for morphologic features and location of tumor, presence of stratification, luminal stenosis, proximal dilatation, adjacent lymph nodes, and correlated with findings at histological examination. Results: The tumor was located in the terminal (n = 6)or distal (n = 1) ileum. On CT-enterography, the tumor was visible in five patients, whereas two patients had no visible tumor. Four different patterns were individualized including small bowel mass (n = 2), long stenosis with heterogeneous submucosal layer (n = 2), short and severe stenosis with proximal small bowel dilatation (n = 2), and sacculated small bowel loop with irregular and asymmetric circumferential thickening (n = 1). Stratification, fat stranding, and comb sign were present in two, two, and one patients, respectively. Conclusion: Identification of a mass being clearly visible suggests strongly the presence of small bowel adenocarcinoma in Crohn disease patients but adenocarcinoma may be completely indistinguishable from benign fibrotic or acute inflammatory stricture. Knowledge of these findings is critical to help suggest the diagnosis of this rare but severe complication of Crohn disease.
KW - Adenocarcinoma
KW - Computed tomography
KW - Crohn disease
KW - Imaging
KW - Intestinal neoplasm
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U2 - 10.1007/s00261-011-9772-3
DO - 10.1007/s00261-011-9772-3
M3 - Article
C2 - 21671043
AN - SCOPUS:84863726024
SN - 0942-8925
VL - 37
SP - 338
EP - 349
JO - Abdominal Imaging
JF - Abdominal Imaging
IS - 3
ER -