Apple core sign (colon)

Changed by Ian Bickle, 23 Jan 2015

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The apple core sign, also known as a napkin ring sign (bowel), is most frequently associated with constriction of the lumen of the colon by a stenosing annular colorectal carcinoma.

Differential diagnosis

The appearance of the apple-core lesion of the colon also can be caused by other diseases ³:

lymphoma with colonic involvement - appears more diffuse
Crohn’s disease
chronic ulcerative colitis
ischaemic colitis
Chlamydia infection
colonic tuberculosis
Helminthoma
colonic amoebiasis
colonic cytomegalovirus
villous adenoma
radiosurgery such as high doses of Cyberknife used for treating unresectable abdominal malignancies

Image 4 Diagram ( update )

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Image 6 Fluoroscopy (Lateral) ( update )

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Image 8 Fluoroscopy ( create )

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