title: Small bowel adenocarcinoma in Crohn disease: CT-enterography features with pathological correlation.
abstract: OBJECTIVE
  The aim of this study was to analyze the clinical, pathological, and CT-enterography findings of small bowel adenocarcinomas in Crohn disease patients.
  
  
  METHODS
  Clinical, histopathological, and imaging findings were retrospectively evaluated in seven Crohn disease patients with small bowel adenocarcinoma. CT-enterography examinations were reviewed for morphologic features and location of tumor, presence of stratification, luminal stenosis, proximal dilatation, adjacent lymph nodes, and correlated with findings at histological examination.
  
  
  RESULTS
  The tumor was located in the terminal (n = 6) or distal (n = 1) ileum. On CT-enterography, the tumor was visible in five patients, whereas two patients had no visible tumor. Four different patterns were individualized including small bowel mass (n = 2), long stenosis with heterogeneous submucosal layer (n = 2), short and severe stenosis with proximal small bowel dilatation (n = 2), and sacculated small bowel loop with irregular and asymmetric circumferential thickening (n = 1). Stratification, fat stranding, and comb sign were present in two, two, and one patients, respectively.
  
  
  CONCLUSIONS
  Identification of a mass being clearly visible suggests strongly the presence of small bowel adenocarcinoma in Crohn disease patients but adenocarcinoma may be completely indistinguishable from benign fibrotic or acute inflammatory stricture. Knowledge of these findings is critical to help suggest the diagnosis of this rare but severe complication of Crohn disease.
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière-APHP and Université Diderot-Paris, France. philippe.soyer@lrb.aphp.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Soyer
authors.forename: Lora
authors.initials: L
authors.lastname: Hristova
authors.forename: Frank
authors.initials: F
authors.lastname: Boudghène
authors.forename: Christine
authors.initials: C
authors.lastname: Hoeffel
authors.forename: Xavier
authors.initials: X
authors.lastname: Dray
authors.forename: Valérie
authors.initials: V
authors.lastname: Laurent
authors.forename: Elliot K
authors.initials: EK
authors.lastname: Fishman
authors.forename: Mourad
authors.initials: M
authors.lastname: Boudiaf
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D000328:Adult; D003287:Contrast Media; D003424:Crohn Disease / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media