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CT Appearance of Some Colonic Villous Tumors

Theodore R. Smith1, Sampson W. Fine2 and Joan G. Jones2

1 Department of Radiology, J. D. Weiler Hospital of the Albert Einstein College of Medicine and Montefiore Medical Center, 1825 Eastchester Rd., Bronx, NY 10461.
2 Department of Pathology, J. D. Weiler Hospital of the Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461.



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  		Fig. 1A. —11.5 x 6.0 cm villous adenoma of cecum (cecal malrotation) in 77-year-old man. Note enhancing convolutional pattern (arrows) visualized in capillary phase of CT scan.

 


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  		Fig. 1B. —11.5 x 6.0 cm villous adenoma of cecum (cecal malrotation) in 77-year-old man. Image obtained using barium enema shows lesion as large irregular filling defect (arrows) in malrotated cecum.

 


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  		Fig. 2A. —6.0 x 4.5 cm villous adenoma of rectum in 76-year-old man. Variegated gyral pattern (arrows) in capillary phase of CT scan. Low-attenuation areas in lesion ranged from 15-17 H.

 


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  		Fig. 2B. —6.0 x 4.5 cm villous adenoma of rectum in 76-year-old man. Photomicrograph of histologic specimen shows patient's normal colonic mucosa. (H and E, x100)

 


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  		Fig. 2C. —6.0 x 4.5 cm villous adenoma of rectum in 76-year-old man. Photomicrograph of histologic specimen obtained from patient shows villous architecture with increased surface area and vascularity (arrows). (H and E, x100)

 


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  		Fig. 3A. —4.0 x 4.0 cm villous adenoma in 83-year-old woman. Polypoid lesion (large arrow) visible on CT scan with lumen collapsed around it. Mass has oral contrast in its interstices producing corrugated pattern. Unusual cluster of mesenteric vessels (small arrows) is adjacent to lesion.

 


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  		Fig. 3B. —4.0 x 4.0 cm villous adenoma in 83-year-old woman. CT scan reveals contiguous section 7 mm superior to A. Lesion is filling defect (black arrows) within opacified lumen. Prominent vessel (white arrows) is in continuity with cluster of mesenteric vessels in A.

 


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  		Fig. 3C. —4.0 x 4.0 cm villous adenoma in 83-year-old woman. Image obtained using barium enema showing lesion (arrow).

 

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