title: Multidetector CT enterography of focal small bowel lesions: a radiological-pathological correlation.
abstract: Focal small bowel lesions present a diagnostic challenge for both the radiologist and gastroenterologist. Both the detection and characterization of small bowel masses have greatly improved with the advent of multidetector CT enterography (MD-CTE). As such, MD-CTE is increasingly utilized in the workup of occult gastrointestinal bleeding. In this article, we review the spectrum of focal small bowel masses with pathologic correlation. Adenocarcinoma, the most common primary small bowel malignancy, presents as a focal irregular mass occasionally with circumferential extension leading to obstruction. Small bowel carcinoid tumors most commonly arise in the ileum and are characterized by avid enhancement and marked desmoplastic response of metastatic lesions. Aneurysmal dilatation of small bowel is pathognomonic for lymphoma and secondary findings of lymphadenopathy and splenomegaly should be sought. Benign small bowel masses such as leiomyoma and adenoma may be responsible for occult gastrointestinal bleeding. However, primary vascular lesions of the small bowel remain the most common cause for occult small bowel gastrointestinal bleeding. The arterial phase of contrast obtained with CTE aids in recognition of the vascular nature of these lesions. Systemic conditions such as Peutz-Jeghers syndrome and Crohn's disease may be suggested by the presence of multiple small bowel lesions. Lastly, potential pitfalls such as ingested material should be considered when faced with focal small bowel masses.
authors.affiliation: Department of Radiology, Beaumont Health, Oakland University William Beaumont School of Medicine, Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.
authors.forename: Farnoosh
authors.initials: F
authors.lastname: Sokhandon
authors.affiliation: Department of Radiology, Beaumont Health, Oakland University William Beaumont School of Medicine, Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA. Sayf.Al-Katib@beaumont.org.
authors.forename: Sayf
authors.identifier: http://orcid.org/0000-0003-0761-661X
authors.initials: S
authors.lastname: Al-Katib
authors.affiliation: Department of Radiology, Beaumont Health, Oakland University William Beaumont School of Medicine, Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Bahoura
authors.affiliation: Department of Radiology, Beaumont Health, Oakland University William Beaumont School of Medicine, Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Copelan
authors.affiliation: Department of Radiology, Beaumont Health, Oakland University William Beaumont School of Medicine, Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: George
authors.affiliation: Department of Radiology, Beaumont Health, Oakland University William Beaumont School of Medicine, Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.
authors.forename: Dominic
authors.initials: D
authors.lastname: Scola
mesh_terms: D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging*; D007414:Intestinal Neoplasms / Q000000981:diagnostic imaging; D007421:Intestine, Small; D014057:Tomography, X-Ray Computed
keywords: CT enterography; Focal small bowel