Carcinoid syndrome CT: Difference between revisions
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==Overview== | ==Overview== | ||
Chest CT scan may be helpful in the diagnosis of carcinoid tumor. On high-resolution CT scan of the chest, peripheral pulmonary carcinoid tumor is characterized by a solitary and round [[pulmonary nodule]] with a lobulated margin, whereas bronchial carcinoid tumor is characterized by a single well-defined, round or ovoid, hilar or perihilar [[mass]] with marked homogenous enhancement. On CT scan of the neck, thymic carcinoid tumor is characterized by a mass with heterogeneous attenuation. | [[Chest]] [[CT scan]] may be helpful in the [[diagnosis]] of [[Carcinoid tumor|carcinoid tumor.]] On [[High-resolution CT|high-resolution]] [[CT scan]] of the [[chest]], peripheral [[pulmonary]] [[carcinoid tumor]] is characterized by a [[solitary]] and round [[pulmonary nodule]] with a lobulated margin, whereas [[bronchial]] [[carcinoid tumor]] is characterized by a single well-defined, round or ovoid, [[hilar]] or perihilar [[mass]] with marked [[homogenous]] [[Enhancement|enhancement.]] On [[CT scan]] of the [[neck]], [[thymic]] [[carcinoid tumor]] is characterized by a [[mass]] with [[heterogeneous]] [[attenuation]]. | ||
==CT== | ==CT== | ||
===Midgut Carcinoids=== | ===Midgut Carcinoids=== | ||
*CT is poor in detecting primary carcinoid | *[[Computed tomography|CT]] is poor in detecting primary [[Carcinoid Tumor|carcinoid tumor]] but helpful in evaluating the [[Extention|extent]] of [[tumour]] [[Spread of the cancer|spread]] before [[Surgeries|surgical]] exploration.<ref name="pmid7619613">{{cite journal |vauthors=Sugimoto E, Lörelius LE, Eriksson B, Oberg K |title=Midgut carcinoid tumours. CT appearance |journal=Acta Radiol |volume=36 |issue=4 |pages=367–71 |date=July 1995 |pmid=7619613 |doi= |url=}}</ref> | ||
*Most common finding is liver | *Most common finding is [[liver]] [[metastases]]. | ||
*Mesenteric | *[[Mesenteric]] [[metastases]] and [[retroperitoneal]] [[adenopathy]] can also be detected. | ||
* | *[[Carcinoid tumor]] that have infiltrated the [[mesentery]] have a characteristic [[Computed tomography|CT]] appearance as a ill-defined [[mesenteric]] [[mass]] containing [[calcification]] in up to 70% of cases.<ref name="pmid3968277">{{cite journal |vauthors=Cockey BM, Fishman EK, Jones B, Siegelman SS |title=Computed tomography of abdominal carcinoid tumor |journal=J Comput Assist Tomogr |volume=9 |issue=1 |pages=38–42 |date=1985 |pmid=3968277 |doi= |url=}}</ref> | ||
*Three-dimensional CT angiography detects mesenteric mass and its relationship to the vessels which is important for surgical planning. | *Three-dimensional [[CT angiography]] detects [[mesenteric]] [[mass]] and its relationship to the [[vessels]] which is important for [[surgical]] planning. | ||
===Peripheral Pulmonary Carcinoid Tumor High-Resolution CT Chest=== | ===Peripheral Pulmonary Carcinoid Tumor High-Resolution CT Chest=== | ||
Findings on high-resolution CT scan suggestive of peripheral pulmonary carcinoid tumor include:<ref name=pulmonaryCT>Peripheral pulmonary carcinoid tumour. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2015. http://radiopaedia.org/articles/peripheral-pulmonary-carcinoid-tumour</ref> | Findings on [[CT scan|high-resolution CT scan]] suggestive of peripheral [[pulmonary]] [[carcinoid tumor]] include:<ref name="pulmonaryCT">Peripheral pulmonary carcinoid tumour. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2015. http://radiopaedia.org/articles/peripheral-pulmonary-carcinoid-tumour</ref> | ||
*Discovered as an incidental solitary and round [[pulmonary nodule]] | *Discovered as an [[Incidental finding|incidental]] [[solitary]] and round [[pulmonary nodule]] | ||
*Size at diagnosis can vary but ranges between 10-30 mm | *Size at diagnosis can vary but ranges between 10-30 mm | ||
*Lobulated margin | *Lobulated margin | ||
===Bronchial Carcinoid Tumor High-Resolution CT Chest=== | ===Bronchial Carcinoid Tumor High-Resolution CT Chest=== | ||
Findings on high-resolution CT scan suggestive of bronchial carcinoid tumor include:<ref>Bronchial carcinoid tumour. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2015. http://radiopaedia.org/articles/bronchial-carcinoid-tumour</ref><ref name="pmid11896225">{{cite journal |vauthors=Jeung MY, Gasser B, Gangi A, Charneau D, Ducroq X, Kessler R, Quoix E, Roy C |title=Bronchial carcinoid tumors of the thorax: spectrum of radiologic findings |journal=Radiographics |volume=22 |issue=2 |pages=351–65 |date=2002 |pmid=11896225 |doi=10.1148/radiographics.22.2.g02mr01351 |url=}}</ref> | Findings on [[CT scan|high-resolution CT scan]] suggestive of [[Carcinoid tumor|bronchial carcinoid tumor]] include:<ref>Bronchial carcinoid tumour. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2015. http://radiopaedia.org/articles/bronchial-carcinoid-tumour</ref><ref name="pmid11896225">{{cite journal |vauthors=Jeung MY, Gasser B, Gangi A, Charneau D, Ducroq X, Kessler R, Quoix E, Roy C |title=Bronchial carcinoid tumors of the thorax: spectrum of radiologic findings |journal=Radiographics |volume=22 |issue=2 |pages=351–65 |date=2002 |pmid=11896225 |doi=10.1148/radiographics.22.2.g02mr01351 |url=}}</ref> | ||
*Well-defined single hilar or perihilar [[mass]] | *Well-defined single [[hilar]] or perihilar [[mass]] | ||
*Round or ovoid in shape | *Round or ovoid in shape | ||
*Variable in size but typically ranges between 2-5 cm | *Variable in size but typically ranges between 2-5 cm | ||
*Marked homogeneous contrast enhancement due to high vascularity | *Marked [[homogeneous]] [[contrast]] enhancement due to high [[vascularity]] | ||
*[[Calcification]] (usually eccentric) can occur | *[[Calcification]] (usually [[Eccentric Lesion|eccentric]]) can occur | ||
===Thymic Carcinoid=== | ===Thymic Carcinoid=== | ||
Findings on neck CT scan suggestive of thymic carcinoid tumor include:<ref name=thymicCT>Thymic carcinoid tumour. Dr Yuranga Weerakkody and Dr Mohammad Taghi Niknejad et al. Radiopaedia 2015. http://radiopaedia.org/articles/thymic-carcinoid-tumour</ref> | Findings on [[neck]] [[CT scan]] suggestive of [[thymic]] [[carcinoid tumor]] include:<ref name="thymicCT">Thymic carcinoid tumour. Dr Yuranga Weerakkody and Dr Mohammad Taghi Niknejad et al. Radiopaedia 2015. http://radiopaedia.org/articles/thymic-carcinoid-tumour</ref> | ||
*Mass with heterogeneous attenuation | *[[Mass]] with [[heterogeneous]] [[attenuation]] | ||
==Gallery== | ==Gallery== | ||
Latest revision as of 19:44, 3 May 2019
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Carcinoid syndrome CT On the Web |
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American Roentgen Ray Society Images of Carcinoid syndrome CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [3]
Overview
Chest CT scan may be helpful in the diagnosis of carcinoid tumor. On high-resolution CT scan of the chest, peripheral pulmonary carcinoid tumor is characterized by a solitary and round pulmonary nodule with a lobulated margin, whereas bronchial carcinoid tumor is characterized by a single well-defined, round or ovoid, hilar or perihilar mass with marked homogenous enhancement. On CT scan of the neck, thymic carcinoid tumor is characterized by a mass with heterogeneous attenuation.
CT
Midgut Carcinoids
- CT is poor in detecting primary carcinoid tumor but helpful in evaluating the extent of tumour spread before surgical exploration.[1]
- Most common finding is liver metastases.
- Mesenteric metastases and retroperitoneal adenopathy can also be detected.
- Carcinoid tumor that have infiltrated the mesentery have a characteristic CT appearance as a ill-defined mesenteric mass containing calcification in up to 70% of cases.[2]
- Three-dimensional CT angiography detects mesenteric mass and its relationship to the vessels which is important for surgical planning.
Peripheral Pulmonary Carcinoid Tumor High-Resolution CT Chest
Findings on high-resolution CT scan suggestive of peripheral pulmonary carcinoid tumor include:[3]
- Discovered as an incidental solitary and round pulmonary nodule
- Size at diagnosis can vary but ranges between 10-30 mm
- Lobulated margin
Bronchial Carcinoid Tumor High-Resolution CT Chest
Findings on high-resolution CT scan suggestive of bronchial carcinoid tumor include:[4][5]
- Well-defined single hilar or perihilar mass
- Round or ovoid in shape
- Variable in size but typically ranges between 2-5 cm
- Marked homogeneous contrast enhancement due to high vascularity
- Calcification (usually eccentric) can occur
Thymic Carcinoid
Findings on neck CT scan suggestive of thymic carcinoid tumor include:[6]
- Mass with heterogeneous attenuation
Gallery
![[7]](/index.php/File:Carcinoid-001.jpg)
![[7]](/index.php/File:Carcinoid-002.jpg)
![[7]](/index.php/File:Carcinoid-003.jpg)
![[7]](/index.php/File:Carcinoid-004.jpg)
References
- ↑ Sugimoto E, Lörelius LE, Eriksson B, Oberg K (July 1995). "Midgut carcinoid tumours. CT appearance". Acta Radiol. 36 (4): 367–71. PMID 7619613.
- ↑ Cockey BM, Fishman EK, Jones B, Siegelman SS (1985). "Computed tomography of abdominal carcinoid tumor". J Comput Assist Tomogr. 9 (1): 38–42. PMID 3968277.
- ↑ Peripheral pulmonary carcinoid tumour. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2015. http://radiopaedia.org/articles/peripheral-pulmonary-carcinoid-tumour
- ↑ Bronchial carcinoid tumour. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2015. http://radiopaedia.org/articles/bronchial-carcinoid-tumour
- ↑ Jeung MY, Gasser B, Gangi A, Charneau D, Ducroq X, Kessler R, Quoix E, Roy C (2002). "Bronchial carcinoid tumors of the thorax: spectrum of radiologic findings". Radiographics. 22 (2): 351–65. doi:10.1148/radiographics.22.2.g02mr01351. PMID 11896225.
- ↑ Thymic carcinoid tumour. Dr Yuranga Weerakkody and Dr Mohammad Taghi Niknejad et al. Radiopaedia 2015. http://radiopaedia.org/articles/thymic-carcinoid-tumour
- ↑ 7.0 7.1 7.2 7.3 Image courtesy of Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia (original file [1]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC