Abstract:OBJECTIVE .A review was made of the CT studies and pathology reports of four patients with surgically resected colonic villous adenomatous tumors, two of whom had focal carcinomatous invasion.CONCLUSION . Two patients had villous tumors with IV contrast-enhancing convolutional gyral patterns. The other two patients had tumor masses that showed oral contrast medium collecting in surface interstices, analogous to findings with barium enemas. One of the latter also had an unusual cluster of mesenteric vessels adj… Show more
“…Villous subtype often appears as a mass with attenuation equal to that of soft tissue at unenhanced CT with convoluted and quite peculiar gyral pattern after IV contrast enhancement, which Chung et al. [11] described at magnetic resonance imaging as mimicking the appearance of cerebral hemisphere. In the case presented previously, a characteristic feature is depicted of what was histologically proved to be a tubulovillous polypoid lesion.…”
The incidental detection of a tubulovillous adenoma at a contrast-enhanced computed tomography (CECT) with nondedicated protocol, performed in emergency conditions, is an uncommon finding. We report a case of a woman presenting with a subocclusive episode. A CECT scan was performed, and a pedunculated polyp could be appreciated at 3D-reconstruction images. A particular depiction of pedunculus of the polypoid lesion, resemble a clapper-bell, could help to define the vegetating lesion at the volume-rendering reconstruction images. This case emphasizes the fundamental role of postprocessing in the clinical practice to improve the diagnostic accuracy of abdominal CT scan. In addition, a potential new radiologic sign, the “clapper-bell sign”, is proposed, as literature about the appearance of a polyp at CECT, performed without a dedicated protocol for colonoscopy, is poor.
“…Villous subtype often appears as a mass with attenuation equal to that of soft tissue at unenhanced CT with convoluted and quite peculiar gyral pattern after IV contrast enhancement, which Chung et al. [11] described at magnetic resonance imaging as mimicking the appearance of cerebral hemisphere. In the case presented previously, a characteristic feature is depicted of what was histologically proved to be a tubulovillous polypoid lesion.…”
The incidental detection of a tubulovillous adenoma at a contrast-enhanced computed tomography (CECT) with nondedicated protocol, performed in emergency conditions, is an uncommon finding. We report a case of a woman presenting with a subocclusive episode. A CECT scan was performed, and a pedunculated polyp could be appreciated at 3D-reconstruction images. A particular depiction of pedunculus of the polypoid lesion, resemble a clapper-bell, could help to define the vegetating lesion at the volume-rendering reconstruction images. This case emphasizes the fundamental role of postprocessing in the clinical practice to improve the diagnostic accuracy of abdominal CT scan. In addition, a potential new radiologic sign, the “clapper-bell sign”, is proposed, as literature about the appearance of a polyp at CECT, performed without a dedicated protocol for colonoscopy, is poor.
“…2 and 3). Central vascular stalk with secondary branches is characteristic [23]. Surgical treatment is indicated as villous tumours have a 10–40 % chance of malignant transformation.Fig.…”
ObjectivesAlthough rectal cancer is by far and large the most common pathology involving the rectum that needs imaging, there are many other important but less common pathological conditions affecting anorectal region. The objective of this pictorial review is to discuss the cross-sectional imaging features of less common anorectal and perirectal diseases.ResultsAlthough a specific histological diagnosis cannot usually be made due to considerable overlap in the imaging appearances of anorectal diseases, this review illustrates the cross-sectional imaging findings with emphasis on magnetic resonance imaging (MRI) that can help in narrowing down the differentials to a reasonable extent.Teaching points• Variety of pathology exists in the anorectum apart from common rectal carcinoma• Anorectal diseases present as non-specific wall thickening indistinguishable from rectal carcinoma• Computed tomography (CT) and MRI can help in narrowing down the differentials, although often biopsy is warranted.
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