Ga Jin Han1, Jin Hee Kim2, Seung Soo Lee1, Seong Ho Park1, Jong Seok Lee1, Hyun Kwon Ha1. 1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, Korea. 2. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, Korea. kimjhrad@amc.seoul.kr.
Abstract
PURPOSE: To investigate the computed tomography (CT) features of pathology-proven inflammatory fibroid polyps (IFPs) in the gastrointestinal tract. METHODS: This retrospective series study included 27 patients with pathology-proven IFPs in the stomach (n = 16), small (n = 9), and large (n = 2) intestine, who underwent contrast-enhanced CT. Two radiologists reviewed the CT images of the patients to determine in consensus the long diameter, shape, margin, contour, and growth pattern of the lesions, the presence of an ulcer and overlying mucosal hyperenhancement, the lesion enhancement patterns including the homogeneity and the degree of contrast enhancement, and the presence of intussusception and obstruction. The CT results and clinical data of the gastric and intestinal lesions were compared. RESULTS: The IFPs typically manifested as well-defined (89%), round or ovoid (81%), slightly lobulated-contoured (70%) masses with a purely endoluminal growth pattern (96%) and an overlying mucosal hyperenhancement (67%). Lesion homogeneity and the degree of contrast enhancement varied. The intestinal IFPs were significantly larger (3.5 vs. 2 cm), more symptomatic (82% vs. 19%), and more frequently associated with intussusception (73% vs. 0%) and obstruction (46% vs. 6%) than the gastric lesions (p ≤ 0.027). CONCLUSIONS: The characteristic CT features of IFPs were well-defined, round or ovoid, lobulated-contoured, and endoluminal masses with overlying mucosal hyperenhancement and various enhancement patterns. IFP should be included in the differential diagnosis of patients with a soft-tissue mass in the gastrointestinal tract, especially if a large endoluminal mass in the small intestine is accompanied by intussusception.
PURPOSE: To investigate the computed tomography (CT) features of pathology-proven inflammatory fibroid polyps (IFPs) in the gastrointestinal tract. METHODS: This retrospective series study included 27 patients with pathology-proven IFPs in the stomach (n = 16), small (n = 9), and large (n = 2) intestine, who underwent contrast-enhanced CT. Two radiologists reviewed the CT images of the patients to determine in consensus the long diameter, shape, margin, contour, and growth pattern of the lesions, the presence of an ulcer and overlying mucosal hyperenhancement, the lesion enhancement patterns including the homogeneity and the degree of contrast enhancement, and the presence of intussusception and obstruction. The CT results and clinical data of the gastric and intestinal lesions were compared. RESULTS: The IFPs typically manifested as well-defined (89%), round or ovoid (81%), slightly lobulated-contoured (70%) masses with a purely endoluminal growth pattern (96%) and an overlying mucosal hyperenhancement (67%). Lesion homogeneity and the degree of contrast enhancement varied. The intestinal IFPs were significantly larger (3.5 vs. 2 cm), more symptomatic (82% vs. 19%), and more frequently associated with intussusception (73% vs. 0%) and obstruction (46% vs. 6%) than the gastric lesions (p ≤ 0.027). CONCLUSIONS: The characteristic CT features of IFPs were well-defined, round or ovoid, lobulated-contoured, and endoluminal masses with overlying mucosal hyperenhancement and various enhancement patterns. IFP should be included in the differential diagnosis of patients with a soft-tissue mass in the gastrointestinal tract, especially if a large endoluminal mass in the small intestine is accompanied by intussusception.
Authors: Faisal Inayat; Asad Ur Rahman; Ahsan Wahab; Amir Riaz; Effa Zahid; Pablo Bejarano; Ronnie Pimentel Journal: J Investig Med High Impact Case Rep Date: 2020 Jan-Dec