Apple core sign - cancer colon

Case contributed by Dr Dalia Ibrahim

Presentation

Bleeding per rectum and abdominal pain.

Patient Data

Age: 50
Gender: Male
Modality: CT

Virtual colonscopy revealed: Apple core with constriction of the hepatic flexure lumen.

Axial CT cuts revealed the neoplastic soft tissue mass involving the hepatic flexure significant encroaching upon its lumen, additionally the CT images clearly illustrates the pericolic smudging as well the enlarged peri-colic lymph nodes.

Modality: Annotated image

Virtual colonscopy revealed: Apple core with constriction of the hepatic flexure lumen.

Axial CT cuts revealed the neoplastic soft tissue mass involving the hepatic flexure significant encroaching upon its lumen, additionally the CT images clearly illustrates the pericolic smudging as well the enlarged peri-colic lymph nodes.

Case Discussion

Apple core sign - colon

  • The apple core sign, also known as a napkin ring sign, is most frequently associated with constriction of the lumen of the colon by a stenosing annular colorectal carcinoma

CT

  • CT is the modality most used for staging colorectal carcinoma, with an accuracy of only between 45-77% 4, able to asses nodes and metastases.
  •  CT colonography is increasing in popularity as an alternative to colonoscopy.
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Case Information

rID: 28747
Case created: 10th Apr 2014
Last edited: 14th Nov 2015
Inclusion in quiz mode: Included

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