Multiple Filling Defects: Causes

Tiny nodules

• Normal Folds
  • Lymphoid hyperplasia presents as multiple tiny (2-4mm) nodules and is associated with giardiasis or immunoglobulin deficiency.
• Thickened folds
  • Lymphangiectasia
  • Whipple's disease
  • Mastocytosis
  • Waldenstrom's macroglobulinemia
  • Infection (Yersinia, MAI, histoplasmosis)

Benign neoplasms

• Leiomyomas
• Carcinoid tumors
• Hemangiomas
• Neurofibromas
• Lipomas (in lipomatosis)
• Polyposis syndromes

Malignant neoplasms

• Metastases may present with multiple, discrete mural masses with variability of size.
• Lymphoma usually represents Non-Hodgkin's lymphoma. It may present with multiple, discrete mural masses with variability of size.
• Carcinoid tumors
• Kaposi's sarcoma

Other mural masses

• Amyloidosis
• Postinflammatory polyps are seen in the healing stages of inflammatory bowel disease.
• Pneumatosis cystoides intestinalis is an idiopathic disorder characterized by gas collections in the intestinal wall, which can result in filling defects on contrast studies.

Intraluminal masses

• Parasites (Ascaris, tapeworms)
• Gallstones
• Food, stool
• Iatrogenic foreign bodies (tubes, catheters, ingested objects)
• Blood clots
• Inverted diverticula

*Gallstones and ingested foreign bodies often lodge at ileocecal juction