A pattern of luminal constriction caused by mucosal erosion and stenosis with ‘shouldering’ of the margins, corresponding to an exophytic encircling and constricting mass in the large intestine lumen
Aetiology Large adenocarcinoma, especially in the left colon, which may obstruct the faecal flow, resulting in pencil-thin stools. The lesion may be partially mimicked by concentric amebomas in Entamoeba histolytica granulomas, by exuberant submucosal fibrosis in Crohn’s disease, by stenosing fibrotic stages of diverticulosis coli, and may occur in small intestinal adenocarcinoma

References in periodicals archive

The apple core appearance is the visual manifestation of an annular lesion of the bowel with irregular overhanging edges and shouldered margins (Figure 23).

(63) The differential diagnosis of a lesion with an apple core appearance is focal diverticulitis, ischemic colitis, ulcerative colitis, endometriosis, amebiasis, serosal metastatic implants, infectious colitis and, rarely, focal amyloidosis.

Classic signs in gastrointestinal radiology

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Apple Core Appearance