Colorectal Cancer CT Manifestations and Differential Diagnosis

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

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Written by Wu Hai Wu
Gastroenterology
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Is dry, pellet-like stool a symptom of colon cancer?

Dry, granular stools are not necessarily symptoms of colon cancer, but patients with colon cancer may also experience dry, granular stools. Therefore, after exhibiting the above symptoms, patients need to promptly complete an electronic colonoscopy to confirm the diagnosis of the disease. For example, if the symptoms are due to colon cancer, aggressive surgical treatment should be taken, followed by comprehensive treatment including radiotherapy and chemotherapy. If the symptoms are due to functional indigestion causing constipation, treatment should involve using medications to regulate the intestinal flora and relieve constipation.

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Written by Sun Wei
Surgical Oncology
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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.

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Written by Yan Chun
Oncology
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What are the early symptoms of colon cancer?

The early symptoms of colon cancer mainly include discomfort and pain in the lower abdomen, which does not necessarily become more pronounced after eating and generally occurs intermittently. Some patients may also experience changes in stool shape, primarily manifested as narrower stools, or an increased frequency of bowel movements per day, leading to diarrhea. Some patients in the early stages may experience worsening of pre-existing constipation, or alternating symptoms of diarrhea and constipation. Some colon cancer patients in the early stages may experience bloody stools, or the presence of mucus, pus, and blood in the stool, which are some atypical gastrointestinal symptoms of colitis. Some patients may also experience nausea.

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Written by Sun Wei
Surgical Oncology
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The most common symptoms of transverse colon cancer

The most common symptoms of transverse colon cancer mainly include abdominal pain, bloody stools, and changes in stool characteristics, such as thinner stools, which can sometimes lead to severe symptoms of intestinal obstruction. After these symptoms appear in transverse colon cancer, it is advisable to undergo a colonoscopy as soon as possible. Pathology obtained through the colonoscopy can confirm the diagnosis. Once transverse colon cancer is confirmed, it is also necessary to check for metastases to other parts of the body. For non-metastasized cases, early surgical treatment should be carried out, including a radical surgery for transverse colon cancer with lymph node dissection. Postoperative comprehensive anti-tumor treatment is generally required, involving six to eight courses of adjuvant chemotherapy. Postoperative chemotherapy aims to prevent local recurrence and distant metastasis.

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Written by Shen Jiang Chao
Radiology
1min 8sec home-news-image

Colorectal Cancer CT Manifestations and Differential Diagnosis

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.