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(Radiographics. 1999;19:1435-1446.)
© RSNA, 1999


SCIENTIFIC EXHIBIT

Unusual Gastric Tumors: Radiologic-Pathologic Correlation1

Seong Ho Park, MD , Joon Koo Han, MD , Tae Kyoung Kim, MD , Joon Woo Lee, MD , Seok-Hyoung Kim, MD , Yong Il Kim, MD , Byung Ihn Choi, MD , Kyung Mo Yeon, MD and Man Chung Han, MD

1 From the Department of Radiology and Institute of Radiation Medicine (S.H.P., J.K.H., T.K.K., J.W.L., B.I.C., K.M.Y., M.C.H.) and the Department of Pathology (S.H.K., Y.I.K.), Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744, Korea. Recipient of a Certificate of Merit award for a scientific exhibit at the 1998 RSNA scientific assembly. Received February 1, 1999; revision requested March 11 and received April 14; accepted April 15. Address reprint requests to J.K.H.

The overlap of radiologic findings in many gastric tumors makes differentiation difficult. However, some unusual gastric tumors have characteristic radiologic features that may suggest a specific diagnosis. At barium study, lipomas typically manifest as a smooth submucosal mass or an ulcerated lesion with a "bull's-eye" appearance that is indistinguishable from other mesenchymal tumors. At computed tomography (CT), lipomas usually manifest as well-circumscribed submucosal masses with fat attenuation. At radiology, glomus tumors appear as smooth submucosal masses with or without ulceration and may contain tiny flecks of calcification. These tumors frequently demonstrate strong enhancement on early-phase contrast material–enhanced images. At barium study, lymphangiomas may appear as smooth intramural masses that are indistinguishable from other mesenchymal tumors. At CT, they manifest as nonenhancing extramucosal masses with homogeneous low attenuation. Diffuse lesions in Brunner gland hamartoma manifest as multiple small nodules, producing a characteristic "cobblestone" appearance. Lymphomas may have typical imaging features (eg, more pronounced and homogeneous mural thickening) that can help differentiate them from adenocarcinoma. In addition, adenocarcinomas may demonstrate unusual findings such as transpyloric spread, unusually large polyps, or intratumoral calcifications. Familiarity with these radiologic features of gastric tumors can help ensure correct diagnosis and proper management.

Index Terms: Adenocarcinoma, 72.321, 72.815 • Carcinoid, 72.316 • Hamartoma, 72.314 • Lipoma, 72.315 • Lymphoma, 72.34 • Paraganglioma, 72.3193 • Stomach, mucosa • Stomach, neoplasms, 72.311, 72.314, 72.315, 72.316, 72.3193, 72.3194, 72.34




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