title: Update on imaging of Peutz-Jeghers syndrome.
abstract: Peutz-Jeghers syndrome (PJS) is a rare, autosomal dominant disease linked to a mutation of the STK 11 gene and is characterized by the development of benign hamartomatous polyps in the gastrointestinal tract in association with a hyperpigmentation on the lips and oral mucosa. Patients affected by PJS have an increased risk of developing gastrointestinal and extra-digestive cancer. Malignancy most commonly occurs in the small-bowel. Extra-intestinal malignancies are mostly breast cancer and gynecological tumors or, to a lesser extent, pancreatic cancer. These polyps are also at risk of acute gastrointestinal bleeding, intussusception and bowel obstruction. Recent guidelines recommend regular small-bowel surveillance to reduce these risks associated with PJS. Small-bowel surveillance allows for the detection of large polyps and the further referral of selected PJS patients for endoscopic enteroscopy or surgery. Video capsule endoscopy, double balloon pushed enteroscopy, multidetector computed tomography and magnetic resonance enteroclysis or enterography, all of which are relatively new techniques, have an important role in the management of patients suffering from PJS. This review illustrates the pathological, clinical and imaging features of small-bowel abnormalities as well as the role and performance of the most recent imaging modalities for the detection and follow-up of PJS patients.
authors.affiliation: Catherine Tomas, Christine Hoeffel, Department of Radiology, Hôpital Robert Debré, 51092 Reims Cedex, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Tomas
authors.affiliation: Catherine Tomas, Christine Hoeffel, Department of Radiology, Hôpital Robert Debré, 51092 Reims Cedex, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Soyer
authors.affiliation: Catherine Tomas, Christine Hoeffel, Department of Radiology, Hôpital Robert Debré, 51092 Reims Cedex, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Dohan
authors.affiliation: Catherine Tomas, Christine Hoeffel, Department of Radiology, Hôpital Robert Debré, 51092 Reims Cedex, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Dray
authors.affiliation: Catherine Tomas, Christine Hoeffel, Department of Radiology, Hôpital Robert Debré, 51092 Reims Cedex, France.
authors.forename: Mourad
authors.initials: M
authors.lastname: Boudiaf
authors.affiliation: Catherine Tomas, Christine Hoeffel, Department of Radiology, Hôpital Robert Debré, 51092 Reims Cedex, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Hoeffel
mesh_terms: D000328:Adult; D001706:Biopsy; D003952:Diagnostic Imaging / Q000379:methods; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010580:Peutz-Jeghers Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D055815:Young Adult
keywords: Abdomen; Abdomen, Magnetic resonance; Computed tomography; Double balloon enteroscopy; Intussusception; Peutz-Jeghers syndrome; Small bowel polyps; Small-bowel disease; Video capsule endoscopy