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Fig. 23B. —Benign versus malignant colonic lesion: importance of lymphadenopathy. 66-year-old man with left-sided abdominal pain. Contrast-enhanced axial CT image at level of descending colon shows mild thickening (long arrow) with fluid and stranding in adjacent paracolic gutter (arrowhead). In addition, cluster of small lymph nodes is seen in adjacent pericolonic fat (short arrow). This finding (lymphadenopathy) is more commonly present in focal adenocarcinoma than in diverticulitis. Surgery revealed adenocarcinoma, and seven of nine lymph nodes tested positive for lymphadenopathy.