Karzinomatose New to Thieme E-Books & E-Journals
Als Karzinose oder. Karzinose. Synonym: Karzinomatose Englisch: carcinosis, carcinomatosis. 1 Definition. Der Begriff Karzinose bezeichnet die diffuse Metastasierung maligner. Zerebrale Symptome. Bei den zerebralen Symptomen führen Kopfschmerzen mit einem Drittel bei allen Patien− ten mit meningealer Karzinomatose; fast ebenso. M. Magenhochzug. Schlauchförmige Umformung des Magens zum Ersatz der Speiseröhre. Magnet-Resonanz-Spektroskopie (MR-Spektroskopie). Die Bildung multipler Metastasen durch ein Malignom wird als Karzinomatose bezeichnet. Dabei infiltrieren die Tochtertumore verschiedene Organsystemen in.
SPIELE HERSTELLER Karzinomatose.
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Peritoneal seeding is predominantly directed by intraperitoneal circulation of peritoneal fluid. Constant circulation of peritoneal fluid allows transcoelomic dissemination of malignant cells.
Their deposition and growth occur at particular sites due to relative stasis of ascitic fluid. Peritoneal carcinomatosis is the most common peritoneal neoplastic condition.
Here we present pictorial review of key CT imaging findings with few of the PC mimics. The presence of ascites is one of the first indicators of peritoneal carcinomatosis Fig.
Loculation of ascitic fluid is further a helpful feature. Subphrenic lymphatic obstruction and malignancy associated excess fluid production are the main causing factors for ascites.
In some cases, ascites is little or absent Fig. Omentum hangs like an apron from the greater curvature of the stomach and the proximal part of the duodenum, thus it covers the majority of the abdominal organs.
Earlier omental involvement can be manifested by smudge pattern invasion of fat, with or without small nodules within the fat Fig.
In later forms, nodular pattern and mixed solid- cystic patterns can be seen Fig. Ovarian carcinoma is considered to be the most common malignancy producing omental cake.
Peritoneal carcinomatosis in year-old female with unknown primary presenting with omental smudge pattern arrow and ascites. Omental deposits in peritoneal carcinomatosis.
Ascites with nodular omental deposits arrowheads. Multiple large mass like omental deposits arrows with ascites noted in different patient with peritoneal carcinomatosis.
Omental cake. Axial CECT image of a year-old female patient with carcinoma stomach showing peritoneal carcinomatosis in the form of omental cake arrowhead.
The mesentery is a double layered peritoneal reflection which suspends the jejunum and the ileum from the posterior abdominal cavity wall. Mesenteric involvement can be manifested by soft-tissue tumor replacement of normal mesenteric fat, in the form of fat stranding, discrete or confluent nodules, mesenteric mass, and anomalous fixation of small bowel loops due to stiff and retractile mesentery, produces characteristic pleated and stellate patterns Fig.
Peritoneal carcinomatosis in year-old male patient of hepatocellular carcinoma with retractile mesentery.
Smooth peritoneal thickening thin arrows and enhancement with central fixation thick arrow of small bowel loops and ascites stars noted. Starry mesentery pattern arrows of peritoneal carcinomatosis in a year-old female case of carcinoma pancreas.
Small bowel mesentery infiltrated with multiple micro and macronodules arrows in a year-old female case of peritoneal carcinomatosis with unknown primary.
A year-old female patient, a follow up case of mucinous cystadenocarcinoma ovary. Mixed solid and cystic peritoneal deposit white arrow with calcified mesenteric deposits curved arrow and ascites consistent with peritoneal carcinomatosis.
Micronodules are difficult to access with imaging alone. It is typically found in subdiaphragmatic spaces Fig.
Morphological categories of those implants can be either solid, cystic, calcified or mixed Fig. PC must be considered as the first possibility in the presence of favorable imaging features even in the absence of detectable primary tumor.
A and B. Large discrete and confluent solid mass like deposits involving the omentum and pelvic peritoneum arrow in two different cases of peritoneal carcinomatosis.
Morphology of peritoneal deposits patterns in peritoneal carcinomatosis. Solid nodular omental and peritoneal deposits White arrow in year-old male patient, a case of hepatocellular carcinoma.
Cystic peritoneal deposits Curved arrow , scalloping the liver surface, mimicking liver cysts in case of mucinous cystadenocarcinoma ovary in a year-old female patient.
Smudge pattern of greater omental involvement star with smooth peritoneal thickening and enhancement. Thickened serosal surface of small and large bowel loops arrow heads with ascites.
A year-old male patient with fibrotic type of tubercular peritonitis. Marked ascites with centrally displaced bowel loops, mimicking peritoneal carcinomatosis.
Splenic microabscesses curved arrow also noted. Peripherally enhancing central hypodense mesenteric lymph nodes arrow. Smooth peritoneal thickening and enhancement.
A year-old male patient, a case of abdominal tuberculosis. Ileocecal wall thickening straight arrow , patulous IC junction arrow head , caseous mesenteric lymphnodes curved arrow with ascites star.
Hepatic and splenic microabscesses arrows. Smooth and regular peritoneal thickening is more in favor of granulomatous peritonitis.
The majority of splenosis implants are found after splenic injury by trauma or after splenectomy. Splenic fragments can become implanted anywhere in the abdominal cavity.
With imaging splenosis appears as dense well circumscribed lesion with attenuation and enhancement patterns similar to splenic parenchyma.
Diffuse peritoneal involvement can be seen in high grade lymphomas, lymphomas complicating AIDS and Burkitt lymphomas. Ascites, mesenteric and omental infiltration also can be noted.
Irregular homogenously enhancing wall thickening involving the ileocaecal region with aneurysmal dilatation of involved segments curved arrow.
Hepatosplenomegaly with hepatic metastasis white arrows. Case of gastric lymphoma. Concentric wall thickening with homogenous contrast enhancement curved arrows , involving the antrum and pylorus of the stomach without causing gastric outlet obstruction.
Soft tissue mass encasing the mesenteric vessels without obstruction white arrow. Pseudomyxoma peritonei PMP is a rare complication of mucinous tumours of appendiceal or ovarian origin that results in peritoneal and omental implants.
The CT signs of pseudomyxoma peritonei are not specific, combining peritoneal effusion, peritoneal nodules and invasion of the greater omentum.
Gelatinous deposits scalloping over the hepatic margins, loculated ascites and curvilinear calcification are pathognomonic features.
The pressure of gelatinous material prevents the bowel loops floating towards the anterior abdominal wall, which may be useful sign in differentiating pseudomyxoma peritonei from ascites.
Mesothelioma is a rare primary tumour of the connective tissue, originates in the serous membranes of the pleura, peritoneum or pericardium.
The extent of carcinomatosis represents one of the most important prognostic factors. In patients with PC accurate preoperative assessment is essential to determine a road map for choosing an optimal type of treatment.
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