Villous Gastrointestinal Tumors: Multimodality Imaging with Histopathologic Correlation

Area of Science:

• Gastroenterology
• Radiology
• Oncology

Background:

• Villous lesions are advanced adenomas found throughout the gastrointestinal tract, most commonly in the colon and duodenum.
• While often sporadic and benign, they can harbor dysplasia and have malignant potential, particularly in hereditary cancer syndromes.
• These lesions are crucial targets for colorectal cancer screening and can present symptomatically, necessitating diagnostic imaging.

Purpose of the Study:

• To highlight the importance of recognizing villous lesions in the gastrointestinal tract.
• To inform radiologists about the characteristic imaging features of villous lesions across multimodality examinations.
• To emphasize the need for awareness of their malignant potential and the ultimate requirement for surgical resection.

Main Methods:

• Review of imaging characteristics of villous lesions.
• Discussion of multimodality imaging techniques including barium fluoroscopy, CT, MRI, and endoscopic US.
• Correlation of imaging findings with histological diagnosis and clinical management.

Main Results:

• Villous lesions exhibit characteristic appearances on various imaging modalities.
• Imaging can detect these lesions but may have limitations in fully assessing dysplasia and malignancy.
• Multimodality imaging is key for identifying morphology and location.

Conclusions:

• Radiologists must be aware of villous lesions and their imaging manifestations throughout the GI tract.
• Despite imaging detection and biopsy, definitive management of villous lesions with malignant potential requires surgical resection.
• Early recognition through screening and diagnostic imaging is vital for patient management.