EURORAD ESR

Case 9291

Adenocarcinoma of oesophagogastric junction

Author(s)
Ionita CC, Ursu CM, Georgescu C
 
Patient
male, 63 year(s)
 
 
  • Figure 1
    Barium swallow

    Prestenotic dilatation of oesophageal lumen, stenosis at gastro-oesophageal junction – PA view. T11 vertebral osteoblastic lesion.

     
    Area of Interest: Contrast agents; Gastrointestinal tract; Oesophagus; Imaging Technique: Fluoroscopy; Procedure: Barium meal; Special Focus: Neoplasia;
     
     
  • Figure 2
    Barium swallow

    Tertiary contractions of the oesophagus and lack of peristaltic waves from about 4 centimetres proximally to the cardia to about 6 centimetres distally. Obvious stenosis and filling defect. Right – posterior oblique...

     
    Area of Interest: Contrast agents; Gastrointestinal tract; Oesophagus; Imaging Technique: Fluoroscopy; Procedure: Barium meal; Special Focus: Neoplasia;
     
     
  • Figure 3
    Barium swallow

    Visible metal clips after laparoscopic cholecystectomy. PA view.

     
    Area of Interest: Contrast agents; Gastrointestinal tract; Oesophagus; Imaging Technique: Fluoroscopy; Procedure: Barium meal; Special Focus: Neoplasia;
     
     
  • Figure 4
    Contrast-enhanced CT
     

    Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent...

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT;

    Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent...

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT;

    Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent...

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT;

    Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent...

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT;

    Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent...

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT;

    Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent...

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT;

    Sagital reconstruction.

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT;
     
     
  • Figure 5
    Contrast-enhanced CT
     

    Left adrenal mass with a mean attenuation value of 38 HU on native images (a) (suggesting a non-adenoma mass [8]).

     
    Area of Interest: Abdomen; Adrenals; Gastrointestinal tract; Imaging Technique: CT; Special Focus: Neoplasia;

    CECT images revealed a 40% washout within 4 minutes (b-g) (not consistent with adrenal metastasis diagnose [9]). That is why the most likely diagnosis is lipid poor adrenal adenoma.

     
    Area of Interest: Abdomen; Adrenals; Gastrointestinal tract; Imaging Technique: CT;

    Arterial phase images showing 100 HU mean attenuation of the adrenal mass.

     
    Area of Interest: Abdomen; Adrenals; Gastrointestinal tract; Imaging Technique: CT;

    Arterial phase images showing 100 HU mean attenuation of the adrenal mass.

     
    Area of Interest: Abdomen; Adrenals; Gastrointestinal tract; Imaging Technique: CT;

    4 minutes delayed scanning after the dynamic contrast enhanced CT showing 60 HU mean attenuation of the adrenal mass. That means a 40% washout occurred within 4 minutes (not consistent with adrenal metastasis diagnose...

     
    Area of Interest: Abdomen; Adrenals; Gastrointestinal tract; Imaging Technique: CT;

    4 minutes delayed scanning after the dynamic contrast enhanced CT showing 60 HU mean attenuation of the adrenal mass. That means a 40% washout occurred within 4 minutes (not consistent with adrenal metastasis diagnose...

     
    Area of Interest: Abdomen; Adrenals; Gastrointestinal tract; Imaging Technique: CT;

    4 minutes delayed scanning after the dynamic contrast enhanced CT showing 60 HU mean attenuation of the adrenal mass. That means a 40% washout occurred within 4 minutes (not consistent with adrenal metastasis diagnose...

     
    Area of Interest: Abdomen; Adrenals; Gastrointestinal tract; Imaging Technique: CT;
     
     
  • Figure 6
    Contrast-enhanced CT
     

    T11 osteoblastic lesion. Osteoblastic metastases from gastric carcinomas are very rare [6]. No biopsy or PET/PETCT was performed in this case but the PSA (prostate specific antigen) level was normal.

     
    Area of Interest: Abdomen; Bones; Gastrointestinal tract; Imaging Technique: CT; Special Focus: Metastases;

    T11 osteoblastic lesion. Osteoblastic metastases from gastric carcinomas are very rare [6]. No biopsy or PET/PETCT was performed in this case but the PSA (prostate specific antigen) level was normal.

     
    Area of Interest: Abdomen; Bones; Gastrointestinal tract; Imaging Technique: CT; Special Focus: Metastases;
     
     
Prestenotic dilatation of oesophageal lumen, stenosis at gastro-oesophageal junction – PA view. T11 vertebral osteoblastic lesion.
 
Tertiary contractions of the oesophagus and lack of peristaltic waves from about 4 centimetres proximally to the cardia to about 6 centimetres distally. Obvious stenosis and filling defect. Right – posterior oblique view.
 
Visible metal clips after laparoscopic cholecystectomy. PA view.
 
Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent lymphadenopathy is clearly delineated.
 
Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent lymphadenopathy is clearly delineated.
 
Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent lymphadenopathy is clearly delineated.
 
Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent lymphadenopathy is clearly delineated.
 
Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent lymphadenopathy is clearly delineated.
 
Axial images (a-c), coronal (d-f) and sagittal (g) reconstructions depicting transmural lesions with irregular outer border, obliteration of the fat plane and invasion of adjacent organs. Large confluent lymphadenopathy is clearly delineated.
 
Sagital reconstruction.
 
Left adrenal mass with a mean attenuation value of 38 HU on native images (a) (suggesting a non-adenoma mass [8]).
 
CECT images revealed a 40% washout within 4 minutes (b-g) (not consistent with adrenal metastasis diagnose [9]). That is why the most likely diagnosis is lipid poor adrenal adenoma.
 
Arterial phase images showing 100 HU mean attenuation of the adrenal mass.
 
Arterial phase images showing 100 HU mean attenuation of the adrenal mass.
 
4 minutes delayed scanning after the dynamic contrast enhanced CT showing 60 HU mean attenuation of the adrenal mass. That means a 40% washout occurred within 4 minutes (not consistent with adrenal metastasis diagnose [9]).
 
4 minutes delayed scanning after the dynamic contrast enhanced CT showing 60 HU mean attenuation of the adrenal mass. That means a 40% washout occurred within 4 minutes (not consistent with adrenal metastasis diagnose [9]).
 
4 minutes delayed scanning after the dynamic contrast enhanced CT showing 60 HU mean attenuation of the adrenal mass. That means a 40% washout occurred within 4 minutes (not consistent with adrenal metastasis diagnose [9]).
 
T11 osteoblastic lesion. Osteoblastic metastases from gastric carcinomas are very rare [6]. No biopsy or PET/PETCT was performed in this case but the PSA (prostate specific antigen) level was normal.
 
T11 osteoblastic lesion. Osteoblastic metastases from gastric carcinomas are very rare [6]. No biopsy or PET/PETCT was performed in this case but the PSA (prostate specific antigen) level was normal.
 
 
 
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