Korean J Gastroenterol.  2014 Apr;63(4):258-261. 10.4166/kjg.2014.63.4.258.

Metastatic Recurrence of Small Bowel Cancer in Crohn's Disease

• Choi JM
• Lee C
• Im JP

• KMID: 1791885
• DOI: http://doi.org/10.4166/kjg.2014.63.4.258

Abstract

No abstract available.

MeSH Terms

Adenocarcinoma, Mucinous/diagnosis
Colonoscopy
Crohn Disease/complications/*pathology
Humans
Intestinal Neoplasms/*diagnosis/pathology/radiography
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Recurrence, Local
Positron-Emission Tomography
Tomography, X-Ray Computed

Figure

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  Fig. 1. (A) Abdomen CT scan shows circumferential wall thickening (arrow-heads) of the small bowel with luminal narrowing and dilated bowel proximal to the obstruction. (B) This lesion was resected by surgery. (C) Microscopic findings show mucinous adeno-carcinoma invading the sub serosa containing signet ring cells (H&E, ×100) and (D) mesenteric lymph node metastases (H&E, ×40).

• 

  Fig. 2. Endoscopic findings. Multiple nodular lesions with erosion are seen in the stomach (A) and duodenum (B). Colonoscopy shows hard nodular mucosa at the anastomotic site (C) and multiple variable sized ulcerations through the entire colon (D).

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  Fig. 3. Staging workup results. (A) Abdomen CT scan shows multifocal enhancing wall thickening (arrowhead) and multiple lymph node enlargements in the retroperitoneum (arrows). (B) Chest CT showed enlarged lymph nodes in the left supraclavicular area (arrowheads), mediastinum (4B), and retrocrural area. (C) PET scan reveals hypermetabolic lymph nodes in the left supraclavicular area (maximal standardized uptake value [SUV] 5.0), mediastinum (4R: maximal SUV 5.1), retrocrural (maximal SUV 5.3), retroperitoneum (left para-aortic: maximal SUV 5.5), and both common iliac area. Additionally, irregular, partial focal hypermetabolism in marrow space is observed. (D) Bone scan shows diffuse increased uptake in whole axial and both proximal appendicular skeletons suggesting early bone marrow involvement.

Reference

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