Intestinal metastases from gastric adenocarcinoma: helical CT findings

PURPOSE: The purpose of this work was to describe the helical CT findings of intestinal metastasis from gastric adenocarcinoma. METHOD: Twenty-three patients with intestinal metastasis from gastric adenocarcinoma found at helical CT were included. CT findings and clinical and pathologic data were reviewed. RESULTS: The most common characteristic finding was target-like concentric bowel wall thickening (thick inner high-outer low, n = 18) involving multiple long segments with progressive thickening of the enhancing inner layer. Fifteen cases (65%) involved multiple sites, and the ascending colon (n = 12) and rectum (n = 11) were the two most common sites. Peritoneal carcinomatosis (n = 15, 65%) and bowel obstruction (n = 14, 61%) were common associated findings. Regarding the primary lesion, the majority was linitis plastica (n = 16) and poorly differentiated adenocarcinoma with or without signet-ring cell differentiation (n = 14). CONCLUSION: Intestinal metastasis from gastric adenocarcinoma, especially of the linitis plastica type, most commonly showed target-like long segmental wall thickening with a characteristically thick inner enhancing layer on helical CT.     

Primary malignant melanoma of the rectum: CT findings in eight patients

PURPOSE: To retrospectively evaluate computed tomographic (CT) findings in patients with pathologically proved primary malignant melanoma of the rectum. MATERIALS AND METHODS: CT scans of eight patients (three men and five women; age range, 38-74 years; mean age, 62 years) with histologically proved primary rectal malignant melanomas were retrospectively evaluated by two radiologists in consensus. Scans were evaluated for the involved site, approximate size and morphologic appearance of the primary mass, degree of perirectal infiltration, and presence or absence of lymphadenopathy, bowel obstruction, and distant metastases. RESULTS: All of the tumors were located in the distal rectum just above the anal verge. The approximate average sizes of the tumors were as follows: length, 4.8 cm (range, 3.8-6.9 cm); width, 3.8 cm (range, 2.8-5.2 cm); and mean diameter, 4.3 cm (range, 3.3-5.8 cm). Tumors usually appeared as polypoid or fungating intraluminal masses (n = 7). Perirectal infiltration commonly extended to the pelvic side wall or the presacral space (n = 5). All eight patients had lymphadenopathy, frequently larger than 3 cm in diameter (n = 3), which most commonly involved the perirectal lymph node station (n = 7). There was no evidence of bowel obstruction in any of the patients. Distant metastasis involving the liver was noted in one patient. CONCLUSION: On CT scans, primary rectal malignant melanomas appeared as bulky intraluminal fungating masses in the distal rectum, focally expanding and obscuring the lumen without causing obstruction, with perirectal infiltration and frequently enlarged lymph nodes.     

CT of patients with right-sided colon cancer and distal ileal thickening

OBJECTIVE: The purpose of this study was to analyze the incidence and primary causes of distal ileal wall thickening in 131 patients with right-sided colon cancer. SUBJECTS AND METHODS: During a 2-year period, 131 patients underwent surgical resection for right-sided colon cancer. Of these patients, we analyzed 13 who had distal ileal wall thickening on CT before surgery and also had the cause determined at pathology. CT findings were analyzed with regard to the morphologic features of colonic tumors, bowel wall involvement patterns of the distal ileum, and changes in the pericolic space. RESULTS: Distal ileal wall thickening occurred in 13 (10%) of the 131 patients who had right-sided colon cancer. Three patients had polypoid colon cancer, whereas the other 10 had infiltrative colon cancer. The mean thickness of the involved colonic segments was 1.6 cm (range, 1.0-2.2 cm) with a mean length of 5.2 cm (range, 2.5-10.0 cm). Pericolic infiltration was mild in six patients and moderate in four patients. The mean length and thickness of the affected ileal segments were 3.2 cm (range, 1.5-6.0 cm) and 1.1 cm (range, 0.7-2.0 cm), respectively. On histopathologic examination, neoplastic processes involved the distal ileum in nine (69%) of the 13 patients. This involvement was caused by either direct tumor invasion in seven patients or lymphatic spread in two. In four patients (31%), nonneoplastic processes with edema and congestion involved the distal ileum. CONCLUSION: The distal ileum may be abnormally thickened in about 10% of patients with right-sided colon cancer; this thickening results from tumor extension (69%) or a nontumorous process (31%).     

Segmental wall thickening in the colonic loop distal to colonic carcinoma at CT: importance and histopathologic correlation

PURPOSE: To determine the importance of the finding of segmental wall thickening in the colonic loop distal to colonic carcinoma at computed tomography (CT) by means of histopathologic correlation. MATERIALS AND METHODS: Thirteen consecutive patients whose helical CT scans showed segmental wall thickening (>1 cm in maximal width, >5 cm in length) in the colonic loop distal to colonic carcinoma were included. The thickness and length of an involved segment, location, morphologic tumor type, CT patterns of wall thickening, and pericolic changes were evaluated. Surgical pathologic findings in all 13 patients were correlated with CT findings. RESULTS: The involved segment distal to the colonic carcinoma showed circumferential wall thickening with a preserved wall layer pattern at CT. Pericolic changes of varying degrees were seen in 10 patients. Histopathologic examination revealed submucosal and subserosal edema (n = 6), chronic inflammation and fibrosis (n = 5), or both (n = 1), and no histopathologic alteration (n = 1). The tumors were mostly fungating (n = 11), larger than 5 cm in the greatest dimension (n = 12), located in the ascending colon (n = 10), and extended to pericolic adipose tissue (n = 11). CONCLUSION: Colonic carcinoma, especially a large fungating type involving the ascending colon with pericolic infiltration, can produce segmental wall thickening in the distal segment at CT, which represents edema or colitis at histopathologic examination.     

Abdominopelvic actinomycosis involving the gastrointestinal tract: CT features.

PURPOSE: To assess the computed tomographic (CT) features of abdominopelvic actinomycosis involving the gastrointestinal tract. MATERIALS AND METHODS: CT scans were analyzed in 18 patients with pathologically proved abdominopelvic actinomycosis involving the gastrointestinal tract. Eight patients had a history of using intrauterine contraceptive devices. Bowel site, wall thickness, length, bowel involvement patterns, inflammatory infiltration, and features of peritoneal or pelvic mass, if present, were evaluated at CT. RESULTS: Of the gastrointestinal tract, the sigmoid colon was most commonly involved (50%). All patients showed concentric (n = 15) or eccentric (n = 3) bowel wall thickening, with a mean thickness of 1.2 cm and a mean length of 8.3 cm. The thickened bowel enhanced homogeneously in nine patients and heterogeneously in the other nine. Inflammatory infiltration was mostly diffuse and severe. In 17 patients, a peritoneal or pelvic mass (mean maximum diameter, 3.2 cm) was seen adjacent to the involved bowel and appeared to be heterogeneously enhanced in most cases; infiltration into the abdominal wall was seen in four patients. CONCLUSION: Actinomycosis should be included in the differential diagnosis when CT scans show bowel wall thickening and regional pelvic or peritoneal mass with extensive infiltration, especially in patients with abdominal pain, fever, leukocytosis, or long-term use of intrauterine contraceptive devices.     

原发性肛管直肠恶性黑色素瘤的CT和MRI表现

目的：探讨原发性肛管一直肠恶性黑色素瘤（AMM）的CT和MRI表现。方法：回顾性分析本院经病理证实的15例AMM患者的临床、CT、MRI和病理资料。11例行CT检查,3例行MRI检查,1例行CT和MRI检查。结果：15例AMM中,10例病变位于直肠远端与肛管交界处,2例位于直肠,3例位于肛管。肿瘤形态呈蕈伞形肿块9例,肠壁环形增厚4例,肠壁未见明显增厚2例。4例有肺部或者肝脏转移,5例有周围淋巴结转移。15例患者均未见明星的肠梗阻征象。CT平扫示肿块呈稍低密度,最大径约2～4cm,增强后强化方式不一,以中度强化为主。MRI示肿瘤在T2wI上以等信号为主,T2wI上以稍高信号为主,DWI上呈高信号,增强后均有明显强化。结论：AMM的CT和MRI表现具有一定特征性;但AMM病灶较大时,MRI信号不具有黑色素瘤特异性的典型信号。CT检查有助于发现远处转移灶,MRI检查对其鉴别诊断有提示价值。     

结直肠腺癌组织学分级与CT表现的关系

目的:探讨不同组织学级别结直肠腺癌CT表现的差异.方法:回顾性分析219例经病理确诊的结直肠腺癌患者临床和CT资料,按组织学分化程度分为高级别结直肠腺癌和低级别结直肠腺癌两组,比较两组患者发病年龄、性别、病变部位、病变肠壁长度及厚度、肠壁增厚形式、强化程度、增强后低密度比例、肠周浸润程度、肠周淋巴结肿大、合并肠梗阻、肝脏和腹膜转移的差异.结果:高级别和低级别结直肠腺癌在病变肠壁增厚形式、肠周浸润程度和肠周淋巴结肿大等方面差异有统计学意义(x2 =21.571、6.613和34.859,P＜0.05),在平均发病年龄、性别比例、病变部位、病变肠壁长度及厚度、强化程度、增强后低密度比例、合并肠梗阻肝脏和腹膜转移等方面差异无统计学意义(P＞0.05).结论:不同组织学级别的结直肠腺癌CT表现有显著差异.相对低级别结直肠腺癌,高级别结直肠腺癌病变肠壁更易呈环形增厚、肠周浸润程度更重、肠周淋巴结肿大更多.     

Colorectal carcinoma: Evaluation with ultrafast CT

We investigated the value of ultrafast computed tomography for the preoperative assessment of colorectal carcinoma. Ultrafast CT demonstrated the primary tumor in 25 (89%) of 28 patients. Local tumor extension was detected with a sensitivity of 90%, a specificity of 78%, and an overall accuracy of 82%. Invasion into adjacent organs was detected with a sensitivity of 80%, a specificity of 91%, and an overall accuracy of 89%. Diagnoses of pericolic or perirectal lymph node metastasis were true-positive in ten, true-negative in 12, false-positive in one, and false-negative in two and those for distant lymph node metastasis were true-positive in four, true-negative in 24, and false-negative in one. Ultrafast CT may be more useful than conventional CT in evaluating local extension and pericolic or perirectal lymph node metastases because it avoids motion artifact.     

原发性肛管直肠恶性黑色素瘤影像学诊断(5例报告及文献复习)

目的探讨原发性肛管直肠恶性黑色素瘤(AMM)的CT和MRI诊断价值。方法回顾性分析经组织病理学证实的AMM5例,其中男2例,女3例。4例行CT检查,1例行MRI检查。结果AMM表现明显蕈伞型肿块充满肠腔不伴肠梗阻(n=4),肠壁明显增厚(n=1);2例伴肠周脂肪浸润,其中1例延伸至骶前间隙;4例伴淋巴结转移,其中1例淋巴结直径>3cm。CT平扫示肿块呈稍低密度影,轻度强化1例、中度强化3例;AMM及其转移灶在MRIT1WI均呈高信号,T2WI为低信号。抑脂T1WI能更好地显示病灶范围及转移灶。结论肛门直肠部AMM可表现为腔内较大蕈伞型肿块,虽充满肠腔,但不伴肠梗阻,同时具较大淋巴结转移及明显肠周脂肪浸润。MRI对鉴别黑色素性AMM有提示价值。     

Radiological features of leiomyomatous tumors of the colon and rectum

PURPOSE: The purpose of this study was to evaluate the radiological features of 12 pathologically proven cases of colorectal leiomyomatous tumors. METHOD: A retrospective analysis of radiologic findings was performed in 12 patients with pathologically proven colorectal leiomyomatous tumors (2 leiomyomas and 10 leiomyosarcomas). Available radiologic studies included abdominal CT scans in 11 patients, double contrast barium studies in 4, and pelvic MRI in 1. On imaging, we evaluated the size, tumor margin (smooth or lobulated), morphologic appearance, growth patterns (endocolic, exocolic, or combined), contrast enhancement patterns, presence or absence of calcification within the tumors, and metastasis. RESULTS: The involved tumor sites were the colon in 2 patients and the rectum in 10. The mean tumor size was 7.9 cm (range 2-15 cm): It was 3.5 cm in leiomyomas and 8.8 cm in leiomyosarcomas. On imaging studies, the tumor margin was smooth in three patients and lobulated in nine, with endocolic growth in one, exocolic in four, and combined in the remaining seven. Eight of the 12 tumors showed varying degrees of internal necrosis with heterogeneous contrast enhancement. Dystrophic calcification was noted in five patients. Metastasis was seen in the liver in three patients at the time of initial diagnosis, and lymphadenopathy was noted in two patients (paraaortic space in one and perirectal space in two). CONCLUSION: Although rare, the diagnosis of leiomyomatous tumor may be suggested especially when the tumor occurring in the colorectum shows exocolic growth or calcification with varying degree of internal necrosis.     

Small-bowel wall thickening related to a long intestinal tube: incidental CT finding mimicking a pathologic condition

PURPOSE: The purpose of this work is to describe the CT findings of small-bowel wall thickening related to a long intestinal tube in patients with bowel obstruction and to discuss the mechanism of this incidental finding. METHOD: Ten consecutive patients with intubation of a long intestinal tube for bowel obstruction were studied retrospectively. Five cases were diagnosed as colon cancer, three as postoperative adhesion, one as Meckel diverticulitis, and one as internal hernia of the small bowel. The history and imaging studies of these patients were reviewed. RESULTS: Small-bowel wall thickening was demonstrated in 6 of the 10 patients on CT. All findings of small-bowel wall thickening were observed along the long intestinal tube. Multiple accordion-shaped pleats were seen in five patients on longitudinal sections of the small bowel. CONCLUSION: Although definitive pathologic proof is lacking, small-bowel wall thickening related to a long intestinal tube was thought to represent a multiply "pleated" normal small bowel along a long intestinal tube.     

Spiral CT of colon cancer: imaging features and role in management.

Colorectal cancer is a common malignancy that results in significant morbidity and mortality. Abdominal computed tomography (CT) is valuable in planning surgery for colon cancer because it can demonstrate regional extension of tumor as well as adenopathy and distant metastases. At CT, colorectal cancer typically appears as a discrete soft-tissue mass that narrows the colonic lumen. Colorectal cancer can also manifest as focal colonic wall thickening and luminal narrowing. Complications of primary colonic malignancies such as obstruction, perforation, and fistula can be readily visualized with CT. At CT, local extension of tumor appears as an extracolic mass or simply as thickening and infiltration of pericolic fat. Extracolic spread is also suggested by loss of fat planes between the colon and adjacent organs. The liver is the predominant organ to be involved with metastases from colorectal cancer. At CT, hepatic metastases usually appear as hypoattenuating masses, which are best visualized during the portal venous phase of liver enhancement. Other common sites of metastases from colon cancer include the lungs, adrenal glands, and bones. Use of CT is critical for identifying recurrences, evaluating anatomic relationships, documenting "normal" postoperative anatomy, and confirming the absence of new lesions during and after therapy.     

Computed tomography in the evaluation of diverticulitis

Computed tomography (CT) was performed in 43 cases of colonic diverticulitis and compared with the contrast-enema examination (CE) in 37 patients. Findings on CT included inflammation of the pericolic fat in 98% of cases, diverticula in 84%, thickening of the colon wall in 70%, a pericolic abscess in 35%, peritonitis in 16%, a fistula in 14%, colon obstruction in 12%, and intramural sinus tracts in 9%. Secondary findings included a distant abscess in 12% and ureteral obstruction in 7%. In addition to detecting ureteral and bladder involvement and distant abscess formation, CT was preferable for demonstrating the extent of pericolic inflammation, which was underestimated with CE in 41% of patients. Differential diagnosis of the CT findings is discussed. The authors indicate that CT should be the initial procedure in patients with suspected diverticulitis, particularly when CE is contraindicated.     

Frequency and CT patterns of bowel wall thickening proximal to cancer of the colon

OBJECTIVE: This study was performed to determine the frequency and patterns of colon wall thickening seen on CT of patients with adenocarcinoma of the colon. MATERIALS AND METHODS: Preoperative abdominal and pelvic CT scans of 185 patients with surgically proven adenocarcinoma of the colon were retrospectively evaluated by three abdominal radiologists for the presence of colon obstruction and colon wall thickening proximal to the colon adenocarcinoma. The distributions and patterns of colon wall thickening were categorized by consensus. CT findings were compared with pathologic findings. Fisher's exact test was used to determine the statistical significance of any associations. RESULTS: Of 185 patients, CT findings of 20 (10.8%) showed colon wall thickening. Of these, the adenocarcinoma obstructed the colon in 19 patients (p < 0.01). Colon obstruction was partial in 10 patients (53%) and complete in nine (47%). Colon wall thickening was contiguous to the tumor in 14 (70%) patients and noncontiguous in six (30%). Segmental and pancolonic, patchy and diffuse, and dependent and nondependent colon wall thickening was observed in 10 patients (50%) in each category. Associated small-bowel wall thickening was shown in 10 (50%) of the 20 patients. Pathologic examination showed colon wall thickening to be due to edema in all cases. CONCLUSION: Colon wall edema can occur proximal to colon adenocarcinoma, is almost always associated with colon obstruction, and is predominantly contiguous with the obstructing adenocarcinoma.     

Malignant colonic obstruction due to extrinsic tumor: palliative treatment with a self-expanding nitinol stent

OBJECTIVE: The purpose of this study was to evaluate the usefulness of self-expanding nitinol stents for palliative treatment of malignant colorectal obstruction caused by unresectable extrinsic tumor, colorectal metastasis, or peritoneal seeding. SUBJECTS AND METHODS: One covered stent and 10 uncovered stents were deployed in eight patients with colorectal obstruction due to extrinsic tumor under fluoroscopic guidance. The sites of obstruction were located in the rectum (n = 5), in the rectosigmoid colon (n = 2), and from the transverse colon to the descending colon (n = 1). Clinical usefulness and complications were analyzed. RESULTS: Stents were placed successfully in all patients. Minor modifications of the delivery system were required in the tortuous rectosigmoid and lower rectum strictures. Symptoms of obstruction were initially resolved in all but one patient. In that patient, the presence of other points of obstruction was suspected. Bowel obstruction recurred in two patients: one obstruction was due to migration of a covered stent 4 days after the procedure, and the other obstruction was due to peritoneal seeding 33 days after the procedure. Both required colostomy or ileostomy. All patients died 12-111 days after stent placement (mean, 56 days). In five patients (63%), colonic obstruction was palliated by placing a stent until the patients' death between 39 and 111 days after stent placement (mean, 62 days). Six complications occurred in four patients and included stent migration (n = 1), anal bleeding (n = 2), anal pain that required analgesia (n = 1), and fever (n = 2). CONCLUSION; This self-expandable nitinol stent adequately palliated 63% of patients with colonic obstruction due to extrinsic tumor in this small series. Patient selection is very important to the success of this treatment.     

CT evaluation of the colon: inflammatory disease.

Computed tomography (CT) is valuable for detection and characterization of many inflammatory conditions of the colon. At CT, a dilated, thickened appendix is suggestive of appendicitis. A 1-4-cm, oval, fatty pericolic lesion with surrounding mesenteric inflammation is diagnostic of epiploic appendagitis. The key to distinguishing diverticulitis from other inflammatory conditions of the colon is the presence of diverticula in the involved segment. In typhlitis, CT demonstrates cecal distention and circumferential thickening of the cecal wall, which may have low attenuation secondary to edema. In radiation colitis, the clinical history is the key to suggesting the diagnosis because the CT findings can be nonspecific. The location of the involved segment and the extent and appearance of wall thickening may help distinguish Crohn disease and ulcerative colitis. In ischemic colitis, CT typically demonstrates circumferential, symmetric wall thickening with fold enlargement. CT findings of graft-versus-host disease include small bowel and colonic wall thickening, which may result in luminal narrowing and separation of bowel loops. In infectious colitis, the site and thickness of colon affected may suggest a specific organism. The amount of wall thickening in pseudomembranous colitis is typically greater than in any other inflammatory disease of the colon except Crohn disease.     

直肠癌低张充气16层螺旋CT扫描的影像学表现

目的探讨直肠癌于低张直肠充气后的CT表现，提高其诊断率。方法对术前经病理证实的147例直肠癌患者进行低张充气后用16层螺旋CT进行容积平扫及增强扫描。逐例观察肿瘤部位、大小，增强特征，生长方式，侵犯层次，管周筋膜情况。管周淋巴结有无肿大，盆腔淋巴结肿大情况，远处有无转移。结果147例中，肿瘤位于上段49例。中段34例，下段64例；肿瘤长径小于10mm13例，11～20mm67例，21～30mm45例，31mm以上22例；肿瘤表现为肠壁局限增厚型70例，肠壁广泛增厚型22例，肿块型38例，肿块溃疡型17例；肿瘤平扫时等密度136例，低密度11例；肿瘤增强时无强化5例，中等度强化126例，明显强化16例；肿瘤未侵犯浆膜及系膜39例，累及浆膜及系膜层108例；管周间隙及筋膜无累及30例，累及117例；管周淋巴结无肿大65例，肿大82例。结论直肠癌的CT表现主要为肿瘤多位于直肠下段，在11～30mm之间，表现为肠壁局限增厚型，肠壁广泛增厚型．肿块型，肿块溃疡型，以局限性肠壁增厚为主；平扫为等密度，增强为中等度强化，多侵犯黏膜及系膜层，管周间隙及筋膜常受累。     

多层螺旋CT对直肠癌和结肠癌的诊断价值

目的:探讨螺旋CT在直肠癌和结肠癌的表现及诊断价值.方法:回顾性分析21例经手术病理证实的直、结肠癌的CT表现及手术病理资料.结果:结肠癌的部位:升结肠癌8例,降结肠癌3例,乙状结肠癌4例,直肠癌6例;组织类型:腺癌16例,黏液腺癌3例,乳头状腺癌1例,类癌1例.CT可见病变肠管增厚,突出腔内肿块,肠腔狭窄及其浆膜面毛糙,病变侵犯邻近器官,淋巴结肿大及远处转移.结论:螺旋CT检查对直、结肠癌诊断和分期具有一定的价值.     

Granulocytic sarcoma of bowel: CT findings

PURPOSE: To evaluate retrospectively the computed tomographic (CT) findings of granulocytic sarcoma of the bowel. MATERIALS AND METHODS: The institutional review boards of all participating institutions approved this study and waived the requirement for informed consent. CT scans were retrospectively reviewed in eight patients (seven men, one woman; age range, 23-71 years; mean age, 46 years) with pathologically proved granulocytic sarcoma of the small and/or large bowel. CT findings were evaluated with regard to the sites, morphologic characteristics, and contrast material enhancement patterns of the lesions, along with other ancillary findings (ie, peritoneal and mesenteric infiltration, ascites, lymphadenopathy, bowel perforation, and obstruction). RESULTS: Eight patients had a total of 13 lesions in the bowel (of which eight were pathologically proved), involving the duodenum (n=1), jejunum (n=2), ileum (n=5), sigmoid colon (n=1), and rectum (n=4); multifocal bowel lesions were noted in four patients. The lesion varied in shape, with wall thickening alone in three of 13 lesions, an intraluminal polypoid mass in four, an exophytic mass in one, and a combination of findings in five. Contrast material enhancement, relative to the back musculature, showed isoattenuation in seven lesions, hyperattenuation in four, and hypoattenuation in two. Five of eight patients had multiple peritoneal masses with diffuse mesenteric or peritoneal infiltration. Ascites was present in six of eight patients; lymphadenopathy (especially in the mesentery), in five; bowel perforation, in two; and bowel obstruction, in one. CONCLUSION: Granulocytic sarcoma of the bowel is characterized by variability in shape and contrast enhancement and has a high predilection for mesenteric and peritoneal spread.     

CT findings in peripheral T-cell lymphoma involving the gastrointestinal tract

PURPOSE: To evaluate whether computed tomography (CT) accurately depicted gastrointestinal tract involvement in peripheral T-cell lymphoma (PTCL). MATERIALS AND METHODS: CT scans were retrospectively reviewed in 14 patients with pathologically proved PTCLs of the gastrointestinal tract for the following considerations: sites, patterns of involvement (ie, morphologic features, bowel wall thickness or mass size, and contrast enhancement pattern), and ancillary findings at other sites (ie, lymphadenopathy, bowel perforation, and involvement of other organs). RESULTS: PTCL involved the stomach in three patients, the small intestine in eight, both the stomach and the small intestine in one, and the sigmoid colon in two; multifocal involvement was seen in three (21%) patients. CT failed to demonstrate the bowel lesions in three of 14 patients. At CT, 11 patients had gastric or bowel wall thickening (n = 10) and a polypoid mass (n = 1). In 10 patients, the gastric or bowel wall thickening was mild (<1 cm) in six, moderate (1-2 cm) in three, and severe (>2 cm) in one. Lymphadenopathy was noted in nine (64%) patients, with the nonbulky type in eight and the bulky type in one. Bowel perforation occurred in four (29%) patients. Other organs were involved in eight (57%) patients. CONCLUSION: CT can depict PTCL involving the gastrointestinal tract if it is not confined to the mucosa. There is a tendency toward preferential jejunal or duodenal involvement, as well as bowel perforation.