ABSTRACT
Several different terms have been used to describe annular carcinomas of the colon. Raoul Bensaude and Georges Gudnaux’ in 1916 said ‘a typical finding with cancer is when the shadow [of contrast] narrows to a small bridge between two broad shadows, looking as if a chunk had been gouged out on each side.’ The finding is recognized and reported as typical even though the ‘first opaque enema as a method for X-ray examination of the colon’ 2 had only been reported in 1904 by Schule’. One of the early masters of the bismuth enema (barium was introduced in 1910 4 ) was Feodor Haenisch of Hamburg, Germany. He wrote about the early diagnosis of cancer of the colon and visited the US to teach his fluoroscopic technique. He described finger-like projections and thin streams of bismuth extending through the narrowed areas of carcinoma. 5 6 Russell Carman in a 1923 review of the roentgenologic signs of colon cancer, in 359 cases examined at the Mayo Clinic, used the term napkin ring in both the pathologic discussion and radiographic figure legends. He described this as a well-known form of scirrhus cancer (Figure 1). He emphasized that, ‘Roentgenologic manifestations of cancer of the colon, as elicited by the opaque enema, are few and simple. Practically there are but two of importance, namely the filling defect and obstruction.’ Apple core lesion (Figure 2) seems to be the preferred term at the viewbox today. (Napkin rings have disappeared from most of the dinner tables in our fast food society.) ‘Napkin ring cancer of the transverse colon.’ Reprinted from Carman’. Roentgenologic signs of cancer of the colon. J. <italic>Radiology,</italic> 4, 147–51, with permission of the RSNA https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781003076568/34c29fd5-5662-4e8f-b58c-badd7fa5d724/content/fig1_1_B.jpg"/> An apple core https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781003076568/34c29fd5-5662-4e8f-b58c-badd7fa5d724/content/fig1_2_B.jpg"/>
