GI imaging: colonic carcinoma: 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 · GI imaging: colonic carcinoma

Sample item

A barium enema shows an annular constricting lesion in the sigmoid colon with shouldered margins and an irregular mucosa. What is this sign called?

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

The answer and the reasoning

B. Apple core sign

An annular carcinoma causes a short segment of circumferential narrowing with abrupt shouldered edges, resembling a bitten apple core. CT colonography and colonoscopy are used for evaluation. Staging is by CT and MRI for the rectum.

Option by option

  • A. Cobblestone sign

    Cobblestone indicates Crohn disease.

  • B. Apple core sign (correct)

    Correct. Annular shouldered stricture is the apple core lesion.

  • C. Thumbprint sign

    Thumbprints indicate wall oedema in ischaemic or infective colitis.

  • D. Lead pipe sign

    Lead pipe indicates chronic ulcerative colitis.

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.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Apple core sign. An annular carcinoma causes a short segment of circumferential narrowing with abrupt shouldered edges, resembling a bitten apple core.

Why is "Cobblestone sign" not the answer?

Cobblestone indicates Crohn disease.

Why is "Thumbprint sign" not the answer?

Thumbprints indicate wall oedema in ischaemic or infective colitis.

Why is "Lead pipe sign" not the answer?

Lead pipe indicates chronic ulcerative colitis.

What concept does this question test?

It tests GI imaging: colonic carcinoma in Radiology. CT colonography and colonoscopy are used for evaluation. Staging is by CT and MRI for the rectum.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 GI imaging: colonic carcinoma?

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.