Morphological Features of Metastatic Tumors of the Large Intestine―Analysis of Radiological Findings Hiroyuki Kobayashi 1 , Tadahiko Fuchigami 1 1Institute of Gastroenterology, Matsuyama Red Cross Hospital Keyword: 転移性大腸癌 , X線像 , 内視鏡像 , X線経過 , 鑑別疾患 pp.1815-1830
Published Date 2003/12/25
DOI https://doi.org/10.11477/mf.1403100710
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 One hundred-and-seventy eight cases of metastatic large intestinal tumors were analysed regarding tumor morphological features on barium enema. Two-thirds of all cases were metastatic tumors from gastric cancer. Radiologically, the most common finding was the tethered folds type(74.4%), which are considered characteristic of metastatic large intestinal lesions. However, there were a few specialized types as follows ; shallow depressed lesions resembling IIc type of early gastric cancer originating from the stomach(1 case), bull's-eye lesion originating from the lung(1 case), and huge mass lesion originating from the kidney(1 case). It was useful to analyse the morphological types, locations and the numbers of metastatic lesions for differential diagnosis of the primary sites and other diseases.

 According to the cases followed-up to more advanced stage by barium enema, stenosis of the affected lesions was characteristic of the more severe cases and mucosal surface with fixed transverse parallel folds developed into cobblestone appearance.

 On the other hand, from the endoscopic viewpoint, metastatic lesions with redness, erosion, and/or ulceration made possible to some degree the diagnosis of malignant tumors which could be verified later by biopsy. However, it was difficult for endoscopic examination to diagnose metastatic lesions which were detectable as slight tethered folds by barium enema. Therefore, we considered that barium enema was the first choice examination to diagnose metastatic tumors of the large intestine.

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