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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.