Adenocarcinoma

Adenocarcinoma appears to be the most common malignant neoplasm of the small intestine. It is a solitary lesion mostly located in the proximal small intestine. It is al

Fig.4. Coronal FLASH image with fat saturation acquired 75 seconds after intravenous injection of gadolinium. Iso-osmotic water solution renders the lumen with low signal intensity, while normal intestinal wall presents with high signal intensity (left). In case of a hyperemic lesion (right), local increased gadolinium uptake generates this light bulb appearance

Fig.4. Coronal FLASH image with fat saturation acquired 75 seconds after intravenous injection of gadolinium. Iso-osmotic water solution renders the lumen with low signal intensity, while normal intestinal wall presents with high signal intensity (left). In case of a hyperemic lesion (right), local increased gadolinium uptake generates this light bulb appearance most always symptomatic, with non-specific clinical presentation and a dismal prognosis, mainly due to a late diagnosis. Its appearances on enteroclysis reflect its pattern of growth and include annular constricting lesions, filling defects, polypoid and/or ulcerated masses, or a combination of the above. Infiltrative adenocarcinomas are the most common type. Adenocarcinoma appears on CT as a solitary, focal, sharply outlined mass, causing thickening of the intestinal wall and narrowing of its lumen. The tumor may be homogeneous or heterogeneous when ulcerated and shows moderate contrast enhancement. Infiltration of the mesentery is seen with advanced disease, whereas associated lymphadenopathy is found in almost 50% of patients at presentation. Predominantly ulcerated adenocarcinomas may simulate lymphomas, malignant gastorintestinal stromal tumors (GISTs) or metastatic melanomas, whereas annular-type lesions will need to be differentiated from secondary adenocarcinoma, carcinoid, tuberculosis or Crohn's disease.

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