Abdominal and GI imaging: mesenteric carcinoid: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Abdominal and GI imaging: mesenteric carcinoid

Sample item

A man with flushing and diarrhoea has a CT showing a calcified mesenteric mass with radiating strands of soft tissue that tether and kink adjacent small bowel loops. What is the most likely diagnosis?

ARetroperitoneal fibrosisBMesenteric lymphomaCPeritoneal carcinomatosisDSmall bowel neuroendocrine tumour with mesenteric metastasis

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Small bowel neuroendocrine tumour with mesenteric metastasis

Carcinoid metastases in the mesentery provoke an intense desmoplastic reaction from serotonin, giving a calcified spoke-wheel mass that kinks the bowel. Liver metastases cause the carcinoid syndrome.

Option by option

A. Retroperitoneal fibrosis
Retroperitoneal fibrosis lies around the aorta and ureters, not in the small bowel mesentery.
B. Mesenteric lymphoma
Lymphoma forms bulky homogeneous nodes, often with the sandwich sign, and rarely calcifies.
C. Peritoneal carcinomatosis
Carcinomatosis gives omental caking, nodules and ascites rather than a single calcified mass.
D. Small bowel neuroendocrine tumour with mesenteric metastasis (correct)
Correct. A calcified mesenteric mass with a desmoplastic spoke-wheel pattern is typical of a small bowel NET.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Small bowel neuroendocrine tumour with mesenteric metastasis. Carcinoid metastases in the mesentery provoke an intense desmoplastic reaction from serotonin, giving a calcified spoke-wheel mass that kinks the bowel.

Why is "Retroperitoneal fibrosis" not the answer?

Retroperitoneal fibrosis lies around the aorta and ureters, not in the small bowel mesentery.

Why is "Mesenteric lymphoma" not the answer?

Lymphoma forms bulky homogeneous nodes, often with the sandwich sign, and rarely calcifies.

Why is "Peritoneal carcinomatosis" not the answer?

Carcinomatosis gives omental caking, nodules and ascites rather than a single calcified mass.

What concept does this question test?

It tests Abdominal and GI imaging: mesenteric carcinoid in Radiology. Liver metastases cause the carcinoid syndrome.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdominal and GI imaging: mesenteric carcinoid?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.