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2015 ; 15
(62
): 274-82
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Mesenteric changes in an ultrasound examination can facilitate the diagnosis of
neuroendocrine tumors of the small intestine
#MMPMID26673610
Smereczy?ski A
; Starzy?ska T
; Ko?aczyk K
J Ultrason
2015[Sep]; 15
(62
): 274-82
PMID26673610
show ga
Neuroendocrine tumors make up an interesting pathology of a variable clinical
picture, prognosis, localization, endocrine activity and degree of malignancy.
AIM: The aim of this paper is to assess whether ultrasonography can be helpful in
diagnosing neuroendocrine tumors in the small intestine by analyzing changes in
the mesentery. MATERIAL AND METHODS: From 1996 to 2013, we encountered 17
patients (9 women and 8 men at the mean age of 57) with a neuroendocrine tumor in
the small intestine. The diagnosis was confirmed in all patients by
pathomorphological examinations. All retrospectively analyzed patients (n =17)
had an abdominal US examination conducted in accordance with the previously
mentioned protocol. RESULTS: Primary neuroendocrine tumors were visualized
ultrasonography in 13 of 17 patients (76.5%). In the remaining 4 patients, tumors
in the small bowel were diagnosed in CT enteroclysis (n = 3) and conventional
enteroclysis (n = 1). Somatostatin receptor scintigraphy and CT enteroclysis
supplemented the ultrasound result by providing information about the stage of
the disease in 7 cases. In most of the 17 patients with a neuroendocrine tumor
diagnosed by ultrasound (n = 11, 64.7%), changes in the mesentery were prevailing
pathological signs that raised suspicion and, consequently, helped localize the
primary lesion. The hypoechoic mesenteric lymph nodes were the greatest (9-18
mm), well-circumscribed, and the largest of them showed signs of vascularization.
The size of hypoechoic lesions in the mesentery ranged from 25 to 53 mm. These
lesions showed moderate blood flow. All of them were single, usually poorly
circumscribed; two lesions showed slight calcifications. CONCLUSIONS: In an
abdominal US examination, 2/3 of patients with neuroendocrine tumors in the small
bowel manifest secondary lesions in the mesentery which are easier to visualize
than the primary focus. 30% of them are manifested as hypoechoic masses. The
detection of such lesions should prompt the search for the primary focus in the
small intestine.