GI

Question 1

Harry’s “big fucking masses” of the abdomen

Answer 1

desmoid
sarcoma
GIST
fibrous tumor
lymphoma

Question 2

ram’s horn deformity of stomach

Answer 2

aka pseudo Billroth I

• Crohn’s
• sarcoidosis (MC GI tract location is stomach)
• TB
• syphilis
• scarring via peptic ulcers
• scirrhous carcinoma

Question 3

low attenuation lymphadenopathy

Answer 3

cystic/necrotic lymph nodes

• metastatic carcinoma
• treated lymphoma
• infection (mycobacterial [TB, MAI], fungal)
• cavitating mesenteric lymph node syndrome in celiac disease (triad: low density LAD sometimes with fat fluid levels, villous atrophy, splenic atrophy)
• inflammatory necrotic disorders (Kikuchi-Fujimoto disease)
• Kaposi sarcoma

fat-containing lymph nodes

• Whipple disease
• extra-adrenal myelolipoma

Question 4

type 1 small bowel folds (thin, straight, dilated lumen)

Answer 4

mechanical obstruction
paralytic ileus
scleroderma
celiac disease/sprue

Question 5

type 2 small bowel folds (thick, straight)

Answer 5

segmental distribution

• ischemia
• radiation enteritis
• intramural hemorrhage
• adjacent inflammatory process

diffuse distribution

• hypoproteinemia (liver dz, nephrotic syndrome)
• venous congestion (CHF)
• cirrhosis

Question 6

type 3 small bowel folds (thick, nodular)

Answer 6

segmental distribution

• Crohns
• infection
• lymphoma
• mets

diffuse distribution

• Whipple disease
• intestinal lymphangiectasia
• nodular lymphoid hyperplasia
• lymphoma
• mets
• polyposis syndromes
• amyloidosis, mastocytosis, eosinophilic gastroenteritis

Question 7

atrophic/featureless small bowel

Answer 7

graft vs host disease (bone marrow transplant)
ischemia (chronic)
celiac disease
radiation enteritis (chronic)
amyloidosis
infectious enteritis

Question 8

excessive fluid in small bowel lumen

Answer 8

proximal to mechanical obstruction
celiac disease/sprue
Zollinger-Ellison syndrome