Colorectal Cancer CT Manifestations and Differential Diagnosis

Written by Shen Jiang Chao
Radiology
Updated on September 12, 2024
00:00
00:00

Early-stage colon cancer is difficult to clearly detect on a CT scan. In the moderate to late stages, colon cancer has more typical manifestations on CT, mainly characterized by thickening of the colon wall, irregular narrowing of the intestinal lumen, and stiffness of the intestinal wall. After enhancement, significant enhancement can be observed. The pericolonic fat space may appear blurred, and in the late stages, small lymph nodes can be seen, and even distant metastasis, most commonly to the liver, can be detected. It is necessary to differentiate colon cancer from colonic inflammation. Inflammatory lesions are usually more widespread and have typical clinical features such as fever and abdominal pain. It is also necessary to differentiate from lymphoma, as lymphomas also cause narrowing of the intestinal lumen but the narrowing is not eccentric and the intestinal wall remains soft, generally not leading to obstruction, whereas in late-stage colon cancer, colonic obstruction can be observed.

Other Voices

doctor image
home-news-image
Written by Si Li Li
Gastroenterology
1min 5sec home-news-image

Is upper gastrointestinal bleeding colon cancer?

Upper gastrointestinal bleeding cannot be caused by colon cancer, as the colon is part of the lower gastrointestinal tract. Therefore, upper gastrointestinal bleeding cannot result from colon cancer. There are several diseases that can cause upper gastrointestinal bleeding: The first common cause is peptic ulcer, including both gastric ulcers and duodenal ulcers, which can lead to bleeding in the upper gastrointestinal tract. The second cause is bleeding due to esophageal or gastric varices rupture associated with liver cirrhosis. This type of bleeding can be substantial and sometimes life-threatening. The third cause is acute gastric mucosal injury, such as that caused by heavy alcohol consumption or the use of nonsteroidal anti-inflammatory drugs (NSAIDs). The fourth cause is gastric cancer, which can lead to upper gastrointestinal tract bleeding. While colon cancer can cause rectal bleeding, it is not a cause of upper gastrointestinal tract bleeding.

doctor image
home-news-image
Written by Chen Tian Jing
Colorectal Surgery
57sec home-news-image

Difference between colon polyps and colon cancer

Colon polyps and colon cancer both belong to organic tumors of the colon mucosa, but the fundamental difference is that colon polyps are mostly benign, while colon cancer is a malignant cancer of the intestines. Both colon cancer and colon polyps require examination by electronic colonoscopy for a definitive diagnosis, and further pathological examination is needed. After the detection of colon polyps, it is necessary to promptly perform radiofrequency ablation surgery under electronic colonoscopy. After the detection of colon cancer, it is necessary to complete relevant pelvic and systemic examinations, and after clarifying the local lesions, surgical removal is performed. Postoperatively, based on the size of the cancerous mass and the extent of the lesion, radiation therapy or chemotherapy may be required.

doctor image
home-news-image
Written by Sun Wei
Surgical Oncology
54sec home-news-image

Is colon cancer surgery a major surgery?

Colon cancer surgery is considered a relatively major procedure, ranking as a class three or four surgery in general surgery. Generally, it involves the resection of the entire transverse colon or tumors located in other areas such as the ascending or descending colon, accompanied by the removal of surrounding lymph nodes, followed by intestinal anastomosis and digestive tract reconstruction. Post-surgery, comprehensive anti-tumor treatment is usually required. After colon cancer surgery, the main focus is on preventing intestinal leakage, which is a serious complication. Dietary intake needs to be gradually restored after surgery. Initially, the patient may only be able to consume liquid and easily digestible foods, gradually transitioning to semi-liquid and regular diets, while also paying attention to eating smaller, more frequent meals.

doctor image
home-news-image
Written by Sun Wei
Surgical Oncology
48sec home-news-image

What to do about liver metastasis from transverse colon cancer?

Liver metastasis in transverse colon cancer is relatively common, especially in cases where the disease has progressed. Because the transverse colon is located close to the liver region, tumors in this area can potentially metastasize to the liver via the lymphatic or blood circulation, or through local infiltration. In cases where the liver metastasis is localized, there is still an opportunity for surgical treatment involving a radical resection of the transverse colon cancer combined with partial hepatectomy. If there are multiple metastases in the liver, radical surgery may not be feasible. Initially, preoperative neoadjuvant chemotherapy or targeted therapy is performed. If the liver metastatic lesions can be reduced or disappear, there may still be a chance for surgical treatment afterwards.

doctor image
home-news-image
Written by Sun Wei
Surgical Oncology
49sec home-news-image

Is minimally invasive surgery suitable for transverse colon cancer?

Transverse colon cancer can also be considered for minimally invasive surgical treatment. The main procedure involves a complete resection of the transverse colon, and sometimes, it may require the resection of part of other organs. For instance, if the cancer has invaded the splenic region of the colon, a splenectomy may be necessary. If there is invasion into the liver area, partial liver resection may be needed. In cases where minimally invasive surgery is not suitable or inconvenient, it is also possible to switch to open surgery. The goal is to completely remove the tumor. Whether minimally invasive or traditional surgery is used, it is just a method of operation. Additionally, postoperative adjunct chemotherapy and other comprehensive treatments are necessary.