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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Barium swallow and endoscopy are complementary procedures in the detection of early esophageal carcinoma. CT is useful in the detection of distant metastases, and mediastinal invasion of key structures such as airway, aorta, and pericardium, but does not reliably differentiate T2 from T3 lesions or define subtle upper abdominal adenopathy. The disparity in reported results from different series published over the last 12 years can be accredited to two causes. First is the lack of uniformity in the way the studies were performed. Most authors agree that slice thickness should be 1 cm and contiguous. Lehr et al used 2-cm slices through the upper abdomen with additional slices through areas of special interest. Similarly, Markland defines his technique as "1-cm intervals from the thoracic inlet to the carina and below this at 1.5 cm intervals to the level of the adrenal glands." Such parameters are hardly optimized for the detection of 8-mm lymph nodes. The other cause of the disparity is interobserver variation in study interpretation. Goei et al staged 35 cases of esophageal cancer using CT. The CT interpretations of each of three readers were subsequently correlated with surgical and pathologic findings of 17 patients. CT pathologic correlation of the three observers showed sensitivities ranging from 50% to 57%, specificities ranging from 50% to 60%, and accuracies ranging from 46% to 71%. CT is useful as a surveillance tool in the postoperative patient. MR imaging does not have a defined role in the workup of esophageal tumors at this time.
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PMID:The radiographic evaluation of the patient with esophageal carcinoma. 804 94

A case of primary intestinal angiosarcoma in a 59-yr-old man is reported. The patient had recurrent gastrointestinal bleeding with normal upper and lower gastrointestinal endoscopies, technetium-99m-labeled erythrocyte scan, and angiography. Barium small bowel series and abdominal computerized tomography showed an ileal mass. Pathological examination was consistent with hemangiosarcoma with both solid and vasoformative patterns. Metastatic disease was also identified in the small bowel mesentery, liver, spleen, lungs, and brain. No identifiable underlying or epidemiologic factors have previously been reported to be associated with this rare type of tumor of the gastrointestinal tract. The pertinent literature on gastrointestinal angiosarcoma also is reviewed.
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PMID:Angiosarcoma of the small intestine: a case report and literature review. 817 59

Secondary involvement of the gastrointestinal tract by malignancies is encountered frequently. It usually reflects a poor prognosis because it is often multicentric and associated with metastases in other organs. Any therapy is usually palliative. Because of this, conventional barium studies or CT is sufficient for diagnosis and can obviate further studies.
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PMID:Metastatic disease involving the gastrointestinal tract. 821 Mar 55

This study was aimed at evaluating CT diagnostic capabilities in detecting carcinoid tumors of the small bowel and comparing CT results with conventional radiographic findings. The CT diagnosis of carcinoid tumor was made in 6 cases based on CT findings. All patients had undergone conventional radiographs (transit or double-contrast studies of the small intestine) and 2 patients had undergone double-contrast barium enema of the colon. 500 ml of oral contrast medium were administered 2 hours, 1 hour and 15 minutes before CT scans, respectively. A hypotonic agent was injected i.v. immediately before the examination. Primary lesion extent, mesenteric involvement, extramesenteric lymph nodes and hepatic metastases were the investigated CT patterns. The first two variables were also assessed on plain radiographs. In all patients the diagnosis of enteric carcinoid tumor was confirmed at surgery or liver biopsy. CT proved to be useful in demonstrating the primary tumor in 5 cases, mesenteric involvement in all patients, liver metastases in 3, lymphadenopathy in none. CT yielded very accurate findings and thus allowed the diagnosis of carcinoid tumor to be made in all the 6 patients, while plain films resulted normal in 2 cases and aspecific in 4. In conclusion, CT, if adequately performed, proved the best technique to detect carcinoid tumors of the small bowel. Of course, further evidence is required.
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PMID:[Computed tomography diagnosis of small intestine carcinoid]. 824 84

The various ultrasound (US) findings in 90 patients with abdominal (gastrointestinal, peritoneal, mesenteric and lymph node) tuberculosis (TB) studied in an area of high incidence of TB over a 1 year period were analysed. The lesions encountered were intestinal (n = 31), extraintestinal (n = 39), or a combination (n = 20). The extraintestinal lesions included free and loculated ascites (n = 36), localized ascites ('Club Sandwich sign') (n = 4), adhesions (n = 14), peritoneal thickening (n = 14), peritoneal nodules (n = 3), lymphadenopathy (n = 23) and cold abscesses (n = 10)-of these, the presence of fine fibrinous strands in the ascetic fluid, localized ascites and caseous or calcified lymph nodes were highly suspicious of a diagnosis of TB in appropriate clinical settings. The bowel lesions were characterized by concentric bowel wall thickening (n = 31) with ulceration in six. Bowel thickening, when present in the ileocaecal junction and especially when situated in the subhepatic position, was suggestive of a tuberculous etiology. Complex masses in the abdomen pointed to an advanced stage of the disease. US is a useful imaging modality in patients clinically suspected of having abdominal TB for diagnosis and follow-up, although in a few cases differentiation of it from metastatic disease is difficult. When bowel involvement is suspected, barium studies should be performed.
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PMID:Sonographic findings in gastrointestinal and peritoneal tuberculosis. 829 28

The records from seventy cases of early gastric cancer (EGC) diagnosed at the Hospital de la Santa Cruz y San Pablo in Barcelona during 1981-1990 were reviewed in order to analyze their clinical features and their influence on survival. There was a male predominance (47/23). The disease was seen mostly in patients who were 60-70 years old, although women were younger than men. The most frequent symptom was epigastric pain, more commonly referred in ulcerated forms of EGC. Protruded forms resulted in digestive haemorrhage. Barium meal examination of the upper digestive tract and gastroscopic examination (without histologic study) only revealed about half of the lesions. So it is very important to get some material for histological studies even in apparently benign lesions. EGC was mostly located at the antrum (68.1%). These antral tumours used to have lymph node metastases more frequently than the rest. Tumours were larger in women than in men. EGC with greater size showed deeper infiltration, more lymph node involvement and higher recurrence risk. Another malignancy--besides EGC--was seen in 8.2% of the patients. This event implied a 40% of mortality. Development of recurrence also meant a high mortality risk. Patients with big, multifocal tumours and with lymph node metastases were prone to recurrence of the disease. In this study, development of recurrence and detection of another malignancy have become the clinical features with more influence over survival.
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PMID:[Early gastric cancer at a third-level hospital in Barcelona in 1981-1990. Clinical considerations]. 839 79

Direct invasion of the transverse colon is known to result from noncontiguous primary tumors spreading along ligamentous attachments or from direct extension of metastatic disease involving the greater omentum. The resultant desmoplastic reaction produces characteristic findings on barium enema. However, to our knowledge, these findings have not been reported to result from extension of a cecal tumor to the transverse colon via the pericolonic fat. We present such a case and discuss the radiographic findings.
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PMID:Direct invasion of the transverse colon by a cecal tumor. 843 87

Endoscopy and barium enema examinations are used to identify the primary site of disease in patients with clinical suspicion of colorectal cancer. Once colorectal cancer has been confirmed by imaging studies and biopsy, preoperative evaluation is directed toward accurate disease staging. Most currently available imaging techniques are inaccurate for detecting transmural extension, perienteric spread of tumors and distant lymph node involvement. Although both computed tomography (CT) and magnetic resonance imaging (MRI) have an unacceptably low sensitivity for accurate staging, CT is clearly superior to MRI for detecting extrahepatic metastases. Transrectal ultrasonography, however, is a promising new method for detecting perirectal spread of disease. The diagnostic efficacy of MRI and intravenous dynamic hepatic CT for detecting liver metastases is approximately equal. CT during arterial portography is recommended before resection of solitary liver metastases. Chest radiography is also part of the routine preoperative evaluation. Bone scans are rarely performed in patients without the skeletal pain suggestive of bone metastases. During the years following surgery for colorectal cancer, many patients undergo special imaging studies to identify local tumor recurrence, secondary tumor growth elsewhere within the large bowel and both regional and distant spread of disease. Thus, for the patient with a sharply increasing carcinoembryonic antigen level, CT of the abdomen and liver is the current recommendation. Immunoscintigraphy is a new imaging modality that addresses some of the limitations of current diagnostic procedures for colorectal cancer. This procedure gives whole body information on disease extent, especially in the extrahepatic abdomen and pelvis, and can therefore contribute to patient management decisions.
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PMID:Current imaging strategies for colorectal cancer. 844 Oct 53

Magnetic resonance (MR) imaging for the preoperative assessment of rectal carcinoma was evaluated. Thirty-three patients underwent MR imaging with a 1.5-T unit. On the basis of results of barium enema studies and/or digital examination, a balloon catheter was inserted to the level of the lesion before MR imaging. Both T1- and T2-weighted axial spin-echo images were obtained in all patients. With the balloon catheter, the three layers of the normal bowel wall could be seen on T2-weighted images. Muscular invasion was detected with a sensitivity of 90%, a specificity of 84%, a positive predictive value of 90%, a negative predictive value of 84%, and an overall accuracy of 88%. False-positive results were related to chemical shift artifact and intramural lymph node metastases. Perirectal fat invasion was detected with a sensitivity of 64%, a specificity of 89%, a positive predictive value of 82%, a negative predictive value of 77%, and an overall accuracy of 79%. One of the false-positive results was related to intramural lymph node metastases and the other to perirectal vessels. Evaluation of adjacent organ invasion was accurate in all patients. Lymph node metastasis was correctly detected in six of nine patients. Absence of lymph node metastasis was correctly predicted in 23 of 24 patients. Thus, MR imaging with a balloon catheter was useful for detection of tumor invasion into muscularis propria and adjacent organs; however, its demonstration of perirectal fat and lymph node involvement was less accurate.
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PMID:Preoperative local staging of rectal carcinoma with MR imaging and a rectal balloon. 844 94

The preoperative evaluation of patients diagnosed as having colon or rectum cancer is influenced by the anatomic location of the primary tumors; the knowledge that 10-25% of patients harbor detectable metastases at time of initial diagnosis; the observation that as many as one-third of patients with isolated metastases may achieve significant survival benefit by aggressive surgery; and the need to accurately stage low rectum cancers to permit selection of appropriate surgery. Patients are evaluated by colonoscopy, air-contrast barium enema when required, computed tomography, and serum carcinoembryonic antigen. Magnetic resonance imaging, especially of the pelvis, may be useful, and endorectal ultrasound has an important role in staging low rectum cancer. A thorough preoperative evaluation is essential in selecting appropriate operative therapy and for sequencing surgery with available adjuvant treatments.
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PMID:Colon and rectum cancer. Patterns of spread and implications for workup. 850 78


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