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Tumors of colon as seen on barium studies- Different types are shown- Differential diagnosis of the external growth with adhesions.
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Apr 12, 2023 S. R. 1
Different Patterns of Colonic Tumors Different Patterns of Colonic Tumors in in
Barium Barium StudiesStudies
Different Patterns of Colonic Tumors Different Patterns of Colonic Tumors in in
Barium Barium StudiesStudies
S. RadS. Rad
Selected Cases from the Personal FileSelected Cases from the Personal File
Tabriz Med. Sc. UniversityTabriz Med. Sc. University
S. RadS. Rad
Selected Cases from the Personal FileSelected Cases from the Personal File
Tabriz Med. Sc. UniversityTabriz Med. Sc. University
Apr 12, 2023 S. R. 2
According to the appearance of According to the appearance of the tumors in barium studies they the tumors in barium studies they are categorized in different types. are categorized in different types. Followings are some examples Followings are some examples for each type.for each type.
According to the appearance of According to the appearance of the tumors in barium studies they the tumors in barium studies they are categorized in different types. are categorized in different types. Followings are some examples Followings are some examples for each type.for each type.
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Polypoid or Fungating types:Polypoid or Fungating types:
They produce bulky mass invading some part of They produce bulky mass invading some part of the colonic lumen and are demonstrated as the the colonic lumen and are demonstrated as the genuine filling defects.genuine filling defects.
They stand usually in the places where there is They stand usually in the places where there is enough room for them to expand such as enough room for them to expand such as rectum and cœcum.rectum and cœcum.
Polypoid or Fungating types:Polypoid or Fungating types:
They produce bulky mass invading some part of They produce bulky mass invading some part of the colonic lumen and are demonstrated as the the colonic lumen and are demonstrated as the genuine filling defects.genuine filling defects.
They stand usually in the places where there is They stand usually in the places where there is enough room for them to expand such as enough room for them to expand such as rectum and cœcum.rectum and cœcum.
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Filling defect shows the Filling defect shows the intraluminal part of the intraluminal part of the
tumortumor
Tumor mass may not be Tumor mass may not be seen in barium study but in seen in barium study but in
the CT, US or MR scansthe CT, US or MR scans
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Barium studies Barium studies delineate only the delineate only the
intra-luminal intra-luminal component of the component of the tumor and to see tumor and to see
the whole extent of the whole extent of the tumor we have the tumor we have
to implement to implement cross-sectional cross-sectional
imaging.imaging.
Barium studies Barium studies delineate only the delineate only the
intra-luminal intra-luminal component of the component of the tumor and to see tumor and to see
the whole extent of the whole extent of the tumor we have the tumor we have
to implement to implement cross-sectional cross-sectional
imaging.imaging.
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Extraluminal component of the
tumors may be small like
carcinomas or large and bulky
such as in sarcomas or lymphomas.
Extraluminal component of the
tumors may be small like
carcinomas or large and bulky
such as in sarcomas or lymphomas.
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Apr 12, 2023 S. R. 9Polypoid tumor with intussusceptionsPolypoid tumor with intussusceptions
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Fecal impaction in the ascending
colon was noticed in the preliminary
scout film we usually take
before barium enema.
To follow…
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……Fecal impaction ( on the right) did not allowed barium Fecal impaction ( on the right) did not allowed barium filling, so we did barium meal ( on the left) and bulky tumor filling, so we did barium meal ( on the left) and bulky tumor was shown in this film.was shown in this film.
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Barium was expelled and this film was taken after that.
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Metastatic gall-bladder carcinoma in Metastatic gall-bladder carcinoma in the colon.the colon.
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Metastatic urinary bladder carcinoma.Metastatic urinary bladder carcinoma.
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Annular Constricting types:Annular Constricting types:
They show usually the shortest filling defects They show usually the shortest filling defects among colon tumors. Initially they invade among colon tumors. Initially they invade unilaterally the lumen to become annular unilaterally the lumen to become annular around it and produce typical around it and produce typical apple coreapple core pattern.pattern.
Annular Constricting types:Annular Constricting types:
They show usually the shortest filling defects They show usually the shortest filling defects among colon tumors. Initially they invade among colon tumors. Initially they invade unilaterally the lumen to become annular unilaterally the lumen to become annular around it and produce typical around it and produce typical apple coreapple core pattern.pattern.
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Apple core pattern and typical Apple core pattern and typical shoulderingshouldering of the margins of the margins
Apple core pattern and typical Apple core pattern and typical shoulderingshouldering of the margins of the margins
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Dilatation of the proximal Dilatation of the proximal segment after a while.segment after a while.
Dilatation of the proximal Dilatation of the proximal segment after a while.segment after a while.
Apple core Apple core patternpattern
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Acute marginal angles or shouldering sign may disappear proximally because of its dilatation
Acute marginal angles or shouldering sign may disappear proximally because of its dilatation
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Polyp
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Once again double Once again double contrast doesn’t show the contrast doesn’t show the tumor but the meal did it tumor but the meal did it
from the pother wayfrom the pother way
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Infiltrating or scirrhous types:Infiltrating or scirrhous types:
They are having more or less long They are having more or less long segment without clear-cut margins with segment without clear-cut margins with the neighborhood and are very alike the neighborhood and are very alike inflammatory processes and are inflammatory processes and are sometimes hard to discriminate.sometimes hard to discriminate.
Infiltrating or scirrhous types:Infiltrating or scirrhous types:
They are having more or less long They are having more or less long segment without clear-cut margins with segment without clear-cut margins with the neighborhood and are very alike the neighborhood and are very alike inflammatory processes and are inflammatory processes and are sometimes hard to discriminate.sometimes hard to discriminate.
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Ulcerating types:Ulcerating types:
Characteristic Characteristic meniscusmeniscus signsign is the milestone is the milestone for diagnosis of these types and they don’t for diagnosis of these types and they don’t differ from the malignant ulcers in the other differ from the malignant ulcers in the other parts of the gastro-intestinal tract concerning parts of the gastro-intestinal tract concerning the overall configuration.the overall configuration.
Ulcerating types:Ulcerating types:
Characteristic Characteristic meniscusmeniscus signsign is the milestone is the milestone for diagnosis of these types and they don’t for diagnosis of these types and they don’t differ from the malignant ulcers in the other differ from the malignant ulcers in the other parts of the gastro-intestinal tract concerning parts of the gastro-intestinal tract concerning the overall configuration.the overall configuration.
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MeniscusMeniscus
UlcerUlcer
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Mural and submucosal types:Mural and submucosal types:
They appear as the external compression They appear as the external compression effects on the barium column unless they effects on the barium column unless they invade lumen in some way. All sarcomas invade lumen in some way. All sarcomas behave in this manner. behave in this manner.
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Fibrosarcoma of Fibrosarcoma of the hipthe hip
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Lymphatic Lymphatic massmass
Lymphatic Lymphatic massmass
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Tumor itself is Tumor itself is not seennot seen
Tethering caused by Tethering caused by adhesionadhesion
Ragged and smooth contourRagged and smooth contourRagged and smooth contourRagged and smooth contour
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Adhesion of Adhesion of the mass to the mass to the colonic the colonic
wallwall
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Metastatic
Hepatoma Gall-bladder tumor
invading colonGall-bladder tumor
invading colon
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Metastatic Metastatic hepatomahepatomaMetastatic Metastatic hepatomahepatoma
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Metastatic Metastatic breast breast
carcinomacarcinoma
Metastatic Metastatic breast breast
carcinomacarcinoma
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Metastatic breast Metastatic breast carcinomacarcinoma
Metastatic breast Metastatic breast carcinomacarcinoma
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Mixed types:Mixed types:
They share all appropriate characters They share all appropriate characters explained for the unique types and are explained for the unique types and are diagnosed easily because of detailed diagnosed easily because of detailed analytic interpretation. analytic interpretation.
Mixed types:Mixed types:
They share all appropriate characters They share all appropriate characters explained for the unique types and are explained for the unique types and are diagnosed easily because of detailed diagnosed easily because of detailed analytic interpretation. analytic interpretation.
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Ileo-rectostomy following total colectomy
Ileo-rectostomy following total colectomy
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Entero-colostomy after hemicolectomy
Entero-colostomy after hemicolectomy
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For hepatic metastasis we use CT scanning or Ultrasonography and occasionally chest x-ray for rectal tumor in cloacogenic type.
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ConclusionConclusion
Diagnosis of the tumors in the colon is usually Diagnosis of the tumors in the colon is usually straight forward if the fluoroscopy is straight forward if the fluoroscopy is implemented. In fact detection of the tumors is implemented. In fact detection of the tumors is made by searching every corner of the colon made by searching every corner of the colon and spot-films are the first step to register and spot-films are the first step to register them during the examination.them during the examination.
The only difficulty remains in discrimination of The only difficulty remains in discrimination of the infiltrative carcinoma and inflammatory the infiltrative carcinoma and inflammatory processes. This will demand a bit of processes. This will demand a bit of experience of course.experience of course.
ConclusionConclusion
Diagnosis of the tumors in the colon is usually Diagnosis of the tumors in the colon is usually straight forward if the fluoroscopy is straight forward if the fluoroscopy is implemented. In fact detection of the tumors is implemented. In fact detection of the tumors is made by searching every corner of the colon made by searching every corner of the colon and spot-films are the first step to register and spot-films are the first step to register them during the examination.them during the examination.
The only difficulty remains in discrimination of The only difficulty remains in discrimination of the infiltrative carcinoma and inflammatory the infiltrative carcinoma and inflammatory processes. This will demand a bit of processes. This will demand a bit of experience of course.experience of course.
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Thanks for your attentionThanks for your attention