Colon: Differential Diagnosis







TABLE 64-1

Multiple Colonic Filling Defects























Artifacts



  • Feces



  • Mucus strands



  • Oil droplets



  • Ingested foreign bodies



  • Air bubbles

Neoplasms and Tumors



  • Multiple adenomatous polyps



  • Hemangiomas



  • Familial adenomatous polyposis



  • Cronkhite-Canada syndrome



  • Disseminated gastrointestinal polyposis



  • Juvenile polyposis coli



  • Turcot’s syndrome



  • Neurocrest and colonic tumors



  • Ruvalcaba-Myhre-Smith syndrome



  • Lymphoma



  • Metastases



  • Multiple adenocarcinomas



  • Cowden’s syndrome



  • Leukemic infiltration



  • Blue nevus syndrome



  • Neurofibromas, neurofibromatosis

INFLAMMATORY DISORDERS



  • Ulcerative colitis



  • Crohn’s disease



  • Diversion colitis



  • C olitis cystica profunda



  • Malacoplakia



  • Behçet’s syndrome

INFECTIOUS DISORDERS



  • Pseudomembranous colitis



  • Amebiasis



  • Schistosomiasis



  • Trichuriasis



  • Strongyloides infection



  • Cytomegalovirus infection



  • Ascariasis



  • Herpes zoster

MISCELLANEOUS DISORDERS



  • Lymphoid follicular pattern



  • Nodular lymphoid hyperplasia



  • Hemorrhoids



  • Diverticula



  • Pneumatosis intestinalis



  • Cystic fibrosis



  • Endometriosis



  • Colonic varices



  • Amyloidosis



  • Hemangiomas



  • Urticaria



TABLE 64-2

Solitary Colonic Filling Defects























BENIGN TUMORS



  • Hyperplastic polyp



  • Adenomatous polyp



  • Villous adenoma



  • Villoglandular polyp



  • Hamartoma



  • Peutz-Jeghers polyp



  • Spindle cell tumor (lipoma, gastrointestinal stromal tumor, fibroma, neurofibroma, cystic lymphangioma)



  • Traumatic neuroma



  • Carcinoid tumor

MALIGNANT TUMORS



  • Carcinoma



  • Lymphoma



  • Metastases



  • Kaposi’s sarcoma

INFECTIOUS DISORDERS



  • Ameboma



  • Tuberculosis



  • Mucormycoma



  • Periappendiceal abscess



  • Diverticular abscess



  • Schistosomiasis (polypoid granuloma)



  • Ascaris lumbricoides (bolus of worms) infection



  • Intramural hematoma

INFLAMMATORY DISORDERS



  • Colitis cystica profunda



  • Solitary rectal ulcer syndrome



  • Foreign body perforation and abscess



  • Crohn’s disease

MISCELLANEOUS DISORDERS



  • Endometrioma



  • Intussusception



  • Bezoar



  • Suture granuloma



  • Inverted appendiceal stump



  • Hypertrophied anal papilla



  • Stool, vegetable material



  • Amyloidosis



  • Varix, hemorrhoid



TABLE 64-3

Mosaic-Submucosal Edema Pattern








  • Obstructive colon cancer



  • Colonic urticaria



  • Herpes zoster



  • Ischemia



  • Cecal volvulus



  • Colonic ileus



  • Yersinia infection



TABLE 64-4

Segmental Colonic Narrowing























MALIGNANT DISORDERS



  • Primary adenocarcinoma



  • Metastases



  • Kaposi’s sarcoma



  • Lymphoma



  • Carcinoma



  • Carcinoid



  • Direct spread from renal, duodenal, pancreatic, ovarian tumor

INFLAMMATORY DISORDERS



  • Crohn’s disease



  • Ulcerative colitis



  • Cathartic colon



  • Caustic colon



  • Retractile mesenteritis



  • Typhlitis



  • Solitary rectal ulcer syndrome

INFECTIOUS DISORDERS



  • Amebiasis



  • Schistosomiasis



  • Strongyloides infection



  • Tuberculosis



  • Gonorrheal proctitis



  • Chlamydia infection (lymphogranuloma venereum)



  • Herpes zoster



  • Cytomegalovirus infection



  • Bacillary dysentery



  • Actinomycosis



  • Giant anorectal condyloma acuminatum



  • Pericolic abscess

VASCULAR DISORDERS



  • Ischemic colitis



  • Radiation colitis



  • Intramural hematoma

MISCELLANEOUS DISORDERS



  • Pancreatitis



  • Pelvic lipomatosis



  • Endometriosis



  • Amyloidosis



  • Adhesive band



  • Postoperative deformity



  • Myochosis



TABLE 64-5

Annular “Apple-Core” Colonic Lesion








  • Carcinoma



  • Diverticulitis



  • Chronic Crohn’s disease



  • Chronic ulcerative colitis



  • Ischemic colitis



  • Chlamydia infection (lymphogranuloma venereum)



  • Lymphoma



  • Tuberculosis



  • Villous adenoma



  • Helminthoma



  • Ameboma



TABLE 64-6

Causes of Large Bowel Obstruction in an Adult































INFLAMMATORY DISORDERS



  • Diverticulitis



  • Inflammatory bowel disease



  • Retractile mesenteritis

INFECTIOUS DISORDERS



  • Ascaris bolus



  • Chagas’ disease



  • Amebiasis



  • Schistosomiasis



  • Actinomycosis



  • Tuberculosis

EXTRINSIC BOWEL LESIONS



  • Adhesions



  • Hernias



  • Volvulus



  • Endometriosis



  • Neoplasms



  • Appendiceal abscess



  • Tubo-ovarian abscess



  • Distended bladder

NEOPLASTIC LESIONS



  • Adenocarcinoma of the colon



  • Lymphoma



  • Spindle cell tumor



  • Gastrointestinal stromal tumor



  • Carcinoid



  • Metastases

VASCULAR DISORDERS



  • Intramural hematoma



  • Vascular occlusion, infarction

OBTURATION OF LUMEN



  • Bezoar



  • Gallstone



  • Enterolith



  • Fecal impaction



  • Foreign body



  • Intussusception

MISCELLANEOUS DISORDERS



  • Amyloidosis



  • Colonic pseudo-obstruction



TABLE 64-7

Intestinal Pseudo-Obstruction: Ogilvie’s Syndrome























DRUG REACTION



  • Phenothiazine



  • Antidepressants



  • Morphine



  • Antiparkinsonian

PARALYTIC ILEUS



  • Hypokalemia



  • Pancreatitis



  • Pneumonia



  • Myocardial infarction



  • Trauma

ENDOCRINE DISEASE



  • Myxedema



  • Diabetes



  • Hypoparathyroidism



  • Pheochromocytoma

NEUROMUSCULAR DISORDERS



  • Parkinson’s disease



  • Chagas’ disease



  • Myotonic dystrophy

MISCELLANEOUS DISORDERS



  • Amyloidosis



  • Sprue



  • Scleroderma



  • Retractile mesenteritis



  • Vitamin D deficiency

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Jun 23, 2019 | Posted by in GASTROINTESTINAL IMAGING | Comments Off on Colon: Differential Diagnosis

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