EURORAD ESR

Case 12540

Small bowel adenocarcinoma arising in ileal Crohn’s disease

Author(s)
Tonolini Massimo, MD 1, Sampietro Gianluca, MD2

(1) Radiology Department
(2) General Surgery - IBD Unit
"Luigi Sacco" University Hospital,
Via G.B. Grassi 74
20157 Milan, Italy;
Email:mtonolini@sirm.org
 
Patient
female, 44 year(s)
 
 
  • Figure 1
    MR-enterography
     

    T2-weighted images showed severe (1.5-2 cm) mural thickening with abnormally increased signal intensity (*) involving a 9 cm ileal segment, focally infiltrating the sigmoid colon (arrowheads). Other ileal segments...

     
    Area of Interest: Small bowel; Imaging Technique: MR; Procedure: Staging; Special Focus: Neoplasia;

    Similarly, unenhanced (b) and post-contrast (c) T1-weighted images showed severe (1.5-2 cm) mural thickening with abnormal signal intensity (*) involving a 9 cm ileal segment, focally infiltrating the sigmoid colon...

     
    Area of Interest: Small bowel; Imaging Technique: MR; Procedure: Staging; Special Focus: Neoplasia;

    Similarly, unenhanced (b) and post-contrast (c) T1-weighted images showed severe (1.5-2 cm) mural thickening with abnormal signal intensity (*) involving a 9 cm ileal segment, focally infiltrating the sigmoid colon...

     
    Area of Interest: Small bowel; Imaging Technique: MR; Procedure: Staging; Special Focus: Neoplasia;

    Axial fat-suppressed (d), sagittal (e) and coronal (f) post-contrast T1-weighted images confirmed prominent enhancement of the markedly thickened ileal segment (*), and of the other mildly thickened segments (arrows).

     
    Area of Interest: Small bowel; Imaging Technique: MR; Procedure: Staging; Special Focus: Neoplasia;

    Axial fat-suppressed (d), sagittal (e) and coronal (f) post-contrast T1-weighted images confirmed prominent enhancement of the markedly thickened ileal segment (*), and of the other mildly thickened segments (arrows).

     
    Area of Interest: Small bowel; Imaging Technique: MR; Procedure: Staging; Special Focus: Neoplasia;

    Axial fat-suppressed (d), sagittal (e) and coronal (f) post-contrast T1-weighted images confirmed prominent enhancement of the markedly thickened ileal segment (*), and of the other mildly thickened segments (arrows).

     
    Area of Interest: Small bowel; Imaging Technique: MR; Procedure: Staging; Special Focus: Neoplasia;
     
     
  • Figure 2
    Unenhanced and contrast-enhanced multidetector CT
     

    Body CT restaging detected a 4 cm inhomogeneous, hypoattenuating and hypoenhancing subcapsular lesion (calipers) in the lower segments of right liver lobe, consistent with adenocarcinoma metastasis.

     
    Area of Interest: Liver; Imaging Technique: CT; Procedure: Staging; Special Focus: Neoplasia;

    Body CT restaging detected a 4 cm inhomogeneous, hypoattenuating and hypoenhancing subcapsular lesion (calipers) in the lower segments of right liver lobe, consistent with adenocarcinoma metastasis.

     
    Area of Interest: Liver; Imaging Technique: CT; Procedure: Staging; Special Focus: Neoplasia;
     
     
T2-weighted images showed severe (1.5-2 cm) mural thickening with abnormally increased signal intensity (*) involving a 9 cm ileal segment, focally infiltrating the sigmoid colon (arrowheads). Other ileal segments showed mild hypointense thickening (arrows).
 
Similarly, unenhanced (b) and post-contrast (c) T1-weighted images showed severe (1.5-2 cm) mural thickening with abnormal signal intensity (*) involving a 9 cm ileal segment, focally infiltrating the sigmoid colon (arrowheads), with prominent contrast enhancement.
 
Similarly, unenhanced (b) and post-contrast (c) T1-weighted images showed severe (1.5-2 cm) mural thickening with abnormal signal intensity (*) involving a 9 cm ileal segment, focally infiltrating the sigmoid colon (arrowheads), with prominent contrast enhancement.
 
Axial fat-suppressed (d), sagittal (e) and coronal (f) post-contrast T1-weighted images confirmed prominent enhancement of the markedly thickened ileal segment (*), and of the other mildly thickened segments (arrows).
 
Axial fat-suppressed (d), sagittal (e) and coronal (f) post-contrast T1-weighted images confirmed prominent enhancement of the markedly thickened ileal segment (*), and of the other mildly thickened segments (arrows).
 
Axial fat-suppressed (d), sagittal (e) and coronal (f) post-contrast T1-weighted images confirmed prominent enhancement of the markedly thickened ileal segment (*), and of the other mildly thickened segments (arrows).
 
Body CT restaging detected a 4 cm inhomogeneous, hypoattenuating and hypoenhancing subcapsular lesion (calipers) in the lower segments of right liver lobe, consistent with adenocarcinoma metastasis.
 
Body CT restaging detected a 4 cm inhomogeneous, hypoattenuating and hypoenhancing subcapsular lesion (calipers) in the lower segments of right liver lobe, consistent with adenocarcinoma metastasis.
 
 
 
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