Abstract
Introduction: Stomach may be affected by number of malignant pathologies like carcinoma, lymphoma, gastrointestinal stromal tumor (GIST) and metastasis. With non-specific clinical presentation and prognosis depending on histological diagnosis and stage at diagnosis necessitates the need for early imaging diagnosis
Aim: To evaluate the imaging appearance in malignant gastric lesions and deduce narrowest differential diagnosis.
Imaging Findings: Of the various imaging modalities available Barium studies allows good mucosal details, however it provides no extragastric assessment which is necessary for disease staging. Multidetector computed tomography (MDCT) is the most commonly used technique for disease assessment allows disease diagnosis, staging and differentiation between various pathologies. Gastric adenocarcinoma and lymphoma account for majority of malignant lesions. Gastric carcinoma may presents as either polypoidal, ulcerative or as diffusely infiltrating lesion mimicking lymphoma, GIST and metastasis. Gastric lymphomatous involvement is usually secondary present as bulky non-obstructing gastric thickening with lymphadenopathy extending below renal hila. GIST is the most common mesenchymal tumor may present as submucosal, intramural or extraluminal mass. Imaging features are exophytic mass with variable enhancement, may show cystic change, hemorrhage or fistulous communication with gut. Metastasis to stomach may be either by direct extension or hematogenous dissemination.
Conclusions: Similar pattern of gastric involvement in seen multitude of malignant etiologies, hence careful evaluation of gastric and ancillary findings is necessary to reach definitive diagnosis.
Keywords: Gastric Carcinoma, Lymphoma, Gastrointestinal stromal tumor(GIST), Metastasis, Multidetector computed tomography.
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Corresponding Author
Dr Renu Yadav MD, DNB, EDiR
Department of Radiodiagnosis, VMMC & SJH, New Delhi
DOI: https://dx.doi.org/10.18535/jmscr/v10i1.18
