HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Park, S. H. Articles by Han, M. C. Search for Related Content PubMed PubMed Citation Articles by Park, S. H. Articles by Han, M. C. Related Collections Gastrointestinal Radiology

Unusual Gastric Tumors: Radiologic-Pathologic Correlation¹

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.

View larger version (149K): [in a new window]   Figure 1a.   Lipoma of the stomach in a 64-year-old woman. (a) Image from a double-contrast barium study shows a well-circumscribed submucosal mass in the gastric antrum (arrows) with limited ulceration (arrowhead). (b) CT scan obtained with water as an oral contrast agent reveals the well-circumscribed submucosal mass with uniform fat attenuation (arrow). The overlying mucosa is clearly seen (arrowhead). (c) Photograph of the resected specimen demonstrates the yellowish tumor composed of fatty tissue.

View larger version (130K): [in a new window]   Figure 1b.   Lipoma of the stomach in a 64-year-old woman. (a) Image from a double-contrast barium study shows a well-circumscribed submucosal mass in the gastric antrum (arrows) with limited ulceration (arrowhead). (b) CT scan obtained with water as an oral contrast agent reveals the well-circumscribed submucosal mass with uniform fat attenuation (arrow). The overlying mucosa is clearly seen (arrowhead). (c) Photograph of the resected specimen demonstrates the yellowish tumor composed of fatty tissue.

View larger version (112K): [in a new window]   Figure 1c.   Lipoma of the stomach in a 64-year-old woman. (a) Image from a double-contrast barium study shows a well-circumscribed submucosal mass in the gastric antrum (arrows) with limited ulceration (arrowhead). (b) CT scan obtained with water as an oral contrast agent reveals the well-circumscribed submucosal mass with uniform fat attenuation (arrow). The overlying mucosa is clearly seen (arrowhead). (c) Photograph of the resected specimen demonstrates the yellowish tumor composed of fatty tissue.

View larger version (132K): [in a new window]   Figure 2a.   Schwannoma of the stomach in a 74-year-old woman. (a) Image from a double-contrast barium study shows a large, well-circumscribed mass in the upper body of the stomach. Note fading out of the mucosal folds around the mass (arrow), a finding that is characteristic of a submucosal tumor. (b) Contrast-enhanced CT scan obtained with water as an oral contrast agent shows the well-circumscribed mass with homogeneous enhancement (arrow).

View larger version (161K): [in a new window]   Figure 2b.   Schwannoma of the stomach in a 74-year-old woman. (a) Image from a double-contrast barium study shows a large, well-circumscribed mass in the upper body of the stomach. Note fading out of the mucosal folds around the mass (arrow), a finding that is characteristic of a submucosal tumor. (b) Contrast-enhanced CT scan obtained with water as an oral contrast agent shows the well-circumscribed mass with homogeneous enhancement (arrow).

View larger version (137K): [in a new window]   Figure 3a.   Glomus tumor of the stomach in a 33-year-old woman. (a) Image from a double-contrast barium study shows a lobulated mass on the gastric angle (black arrows). Ulceration is seen centrally (white arrow). (b) Unenhanced CT scan shows the well-circumscribed mass with small flecks of calcification (arrows). (c) On an early-phase contrast-enhanced CT scan, the mass is greatly enhanced. (d) On an equilibrium-phase CT scan, the mass is less enhanced. (e) Photograph of the gastrectomy specimen shows the submucosal mass with central ulceration (arrow). (f) High-power photomicrograph (original magnification, x200; hematoxylin-eosin [H-E] stain) of the tumor specimen reveals small glomus cells intermixed with numerous small vessels (arrows).

View larger version (154K): [in a new window]   Figure 3b.   Glomus tumor of the stomach in a 33-year-old woman. (a) Image from a double-contrast barium study shows a lobulated mass on the gastric angle (black arrows). Ulceration is seen centrally (white arrow). (b) Unenhanced CT scan shows the well-circumscribed mass with small flecks of calcification (arrows). (c) On an early-phase contrast-enhanced CT scan, the mass is greatly enhanced. (d) On an equilibrium-phase CT scan, the mass is less enhanced. (e) Photograph of the gastrectomy specimen shows the submucosal mass with central ulceration (arrow). (f) High-power photomicrograph (original magnification, x200; hematoxylin-eosin [H-E] stain) of the tumor specimen reveals small glomus cells intermixed with numerous small vessels (arrows).

View larger version (148K): [in a new window]   Figure 3c.   Glomus tumor of the stomach in a 33-year-old woman. (a) Image from a double-contrast barium study shows a lobulated mass on the gastric angle (black arrows). Ulceration is seen centrally (white arrow). (b) Unenhanced CT scan shows the well-circumscribed mass with small flecks of calcification (arrows). (c) On an early-phase contrast-enhanced CT scan, the mass is greatly enhanced. (d) On an equilibrium-phase CT scan, the mass is less enhanced. (e) Photograph of the gastrectomy specimen shows the submucosal mass with central ulceration (arrow). (f) High-power photomicrograph (original magnification, x200; hematoxylin-eosin [H-E] stain) of the tumor specimen reveals small glomus cells intermixed with numerous small vessels (arrows).

View larger version (146K): [in a new window]   Figure 3d.   Glomus tumor of the stomach in a 33-year-old woman. (a) Image from a double-contrast barium study shows a lobulated mass on the gastric angle (black arrows). Ulceration is seen centrally (white arrow). (b) Unenhanced CT scan shows the well-circumscribed mass with small flecks of calcification (arrows). (c) On an early-phase contrast-enhanced CT scan, the mass is greatly enhanced. (d) On an equilibrium-phase CT scan, the mass is less enhanced. (e) Photograph of the gastrectomy specimen shows the submucosal mass with central ulceration (arrow). (f) High-power photomicrograph (original magnification, x200; hematoxylin-eosin [H-E] stain) of the tumor specimen reveals small glomus cells intermixed with numerous small vessels (arrows).

View larger version (143K): [in a new window]   Figure 3e.   Glomus tumor of the stomach in a 33-year-old woman. (a) Image from a double-contrast barium study shows a lobulated mass on the gastric angle (black arrows). Ulceration is seen centrally (white arrow). (b) Unenhanced CT scan shows the well-circumscribed mass with small flecks of calcification (arrows). (c) On an early-phase contrast-enhanced CT scan, the mass is greatly enhanced. (d) On an equilibrium-phase CT scan, the mass is less enhanced. (e) Photograph of the gastrectomy specimen shows the submucosal mass with central ulceration (arrow). (f) High-power photomicrograph (original magnification, x200; hematoxylin-eosin [H-E] stain) of the tumor specimen reveals small glomus cells intermixed with numerous small vessels (arrows).

View larger version (186K): [in a new window]   Figure 3f.   Glomus tumor of the stomach in a 33-year-old woman. (a) Image from a double-contrast barium study shows a lobulated mass on the gastric angle (black arrows). Ulceration is seen centrally (white arrow). (b) Unenhanced CT scan shows the well-circumscribed mass with small flecks of calcification (arrows). (c) On an early-phase contrast-enhanced CT scan, the mass is greatly enhanced. (d) On an equilibrium-phase CT scan, the mass is less enhanced. (e) Photograph of the gastrectomy specimen shows the submucosal mass with central ulceration (arrow). (f) High-power photomicrograph (original magnification, x200; hematoxylin-eosin [H-E] stain) of the tumor specimen reveals small glomus cells intermixed with numerous small vessels (arrows).

View larger version (151K): [in a new window]   Figure 4a.   Lymphangioma of the stomach in a 57-year-old man. (a) Image from a double-contrast barium study shows a mass with a smooth surface and a broad base on the gastric angle (arrows). (b) Contrast-enhanced CT scan obtained with water as an oral contrast agent shows the lentiform submucosal mass with homogeneous low attenuation (arrow).

View larger version (163K): [in a new window]   Figure 4b.   Lymphangioma of the stomach in a 57-year-old man. (a) Image from a double-contrast barium study shows a mass with a smooth surface and a broad base on the gastric angle (arrows). (b) Contrast-enhanced CT scan obtained with water as an oral contrast agent shows the lentiform submucosal mass with homogeneous low attenuation (arrow).

View larger version (125K): [in a new window]   Figure 5a.   Brunner gland hamartoma in the pylorus causing gastroduodenal intussusception in a 48-year-old woman. (a) Image from a double-contrast barium study shows distally tapered barium streaks in the duodenum representing intussusceptum (white arrows) and the "coiled spring" appearance of the duodenum (open arrows). A lobulated filling defect in the duodenojejunal junction (solid black arrow) suggests a lead point. (b) Photograph of the gastrectomy specimen shows the polypoid lesion with ulceration (white arrow) and a long (5-cm) stalk (black arrow) at the pylorus of the stomach. D = duodenum, P = pylorus, S = stomach. Scale is in centimeters.

View larger version (107K): [in a new window]   Figure 5b.   Brunner gland hamartoma in the pylorus causing gastroduodenal intussusception in a 48-year-old woman. (a) Image from a double-contrast barium study shows distally tapered barium streaks in the duodenum representing intussusceptum (white arrows) and the "coiled spring" appearance of the duodenum (open arrows). A lobulated filling defect in the duodenojejunal junction (solid black arrow) suggests a lead point. (b) Photograph of the gastrectomy specimen shows the polypoid lesion with ulceration (white arrow) and a long (5-cm) stalk (black arrow) at the pylorus of the stomach. D = duodenum, P = pylorus, S = stomach. Scale is in centimeters.

View larger version (160K): [in a new window]   Figure 6a.   Carcinoid tumor of the stomach in a 66-year-old man. (a) Image from a double-contrast barium study shows a polypoid lesion in the gastric fundus (white arrow) with a lobulated surface and ulceration (black arrow). (b) Photograph of the gastrectomy specimen demonstrates the 2.5-cm polypoid mass with central ulceration in the gastric fundus (arrow).

View larger version (135K): [in a new window]   Figure 6b.   Carcinoid tumor of the stomach in a 66-year-old man. (a) Image from a double-contrast barium study shows a polypoid lesion in the gastric fundus (white arrow) with a lobulated surface and ulceration (black arrow). (b) Photograph of the gastrectomy specimen demonstrates the 2.5-cm polypoid mass with central ulceration in the gastric fundus (arrow).

View larger version (128K): [in a new window]   Figure 7a.   Low-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach in a 48-year-old man. (a) Image from a double-contrast barium study shows diffuse nodularity of the gastric wall from the high body to the antrum. (b) Photograph of the gastrectomy specimen clearly depicts diffuse nodularity of the gastric mucosa. (c) Low-power photomicrograph (original magnification, x10; H-E stain) reveals lymphoma cells (blue stain) diffusely infiltrating the mucosa and submucosa.

View larger version (149K): [in a new window]   Figure 7b.   Low-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach in a 48-year-old man. (a) Image from a double-contrast barium study shows diffuse nodularity of the gastric wall from the high body to the antrum. (b) Photograph of the gastrectomy specimen clearly depicts diffuse nodularity of the gastric mucosa. (c) Low-power photomicrograph (original magnification, x10; H-E stain) reveals lymphoma cells (blue stain) diffusely infiltrating the mucosa and submucosa.

View larger version (111K): [in a new window]   Figure 7c.   Low-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach in a 48-year-old man. (a) Image from a double-contrast barium study shows diffuse nodularity of the gastric wall from the high body to the antrum. (b) Photograph of the gastrectomy specimen clearly depicts diffuse nodularity of the gastric mucosa. (c) Low-power photomicrograph (original magnification, x10; H-E stain) reveals lymphoma cells (blue stain) diffusely infiltrating the mucosa and submucosa.

View larger version (152K): [in a new window]   Figure 8a.   High-grade MALT lymphoma of the stomach in a 53-year-old woman. (a, b) Images from a double-contrast barium study that were obtained with the patient in different positions show multiple masses of variable size in the body and antrum of the stomach (solid arrows). Some of the masses have ulceration (arrowheads in b). Some nodular lesions (open arrow in b) are also seen in the duodenal bulb and proved to be transpyloric extension of gastric lymphoma at endoscopic biopsy. (c) CT scan shows wall thickening of the gastric antrum (white arrows) and several masses on the gastric wall (black arrows). (d) Photograph of the gastrectomy specimen reveals multiple masses in the body and antrum of the stomach (arrows), some of which have ulceration (arrowheads).

View larger version (163K): [in a new window]   Figure 8b.   High-grade MALT lymphoma of the stomach in a 53-year-old woman. (a, b) Images from a double-contrast barium study that were obtained with the patient in different positions show multiple masses of variable size in the body and antrum of the stomach (solid arrows). Some of the masses have ulceration (arrowheads in b). Some nodular lesions (open arrow in b) are also seen in the duodenal bulb and proved to be transpyloric extension of gastric lymphoma at endoscopic biopsy. (c) CT scan shows wall thickening of the gastric antrum (white arrows) and several masses on the gastric wall (black arrows). (d) Photograph of the gastrectomy specimen reveals multiple masses in the body and antrum of the stomach (arrows), some of which have ulceration (arrowheads).

View larger version (136K): [in a new window]   Figure 8c.   High-grade MALT lymphoma of the stomach in a 53-year-old woman. (a, b) Images from a double-contrast barium study that were obtained with the patient in different positions show multiple masses of variable size in the body and antrum of the stomach (solid arrows). Some of the masses have ulceration (arrowheads in b). Some nodular lesions (open arrow in b) are also seen in the duodenal bulb and proved to be transpyloric extension of gastric lymphoma at endoscopic biopsy. (c) CT scan shows wall thickening of the gastric antrum (white arrows) and several masses on the gastric wall (black arrows). (d) Photograph of the gastrectomy specimen reveals multiple masses in the body and antrum of the stomach (arrows), some of which have ulceration (arrowheads).

View larger version (153K): [in a new window]   Figure 8d.   High-grade MALT lymphoma of the stomach in a 53-year-old woman. (a, b) Images from a double-contrast barium study that were obtained with the patient in different positions show multiple masses of variable size in the body and antrum of the stomach (solid arrows). Some of the masses have ulceration (arrowheads in b). Some nodular lesions (open arrow in b) are also seen in the duodenal bulb and proved to be transpyloric extension of gastric lymphoma at endoscopic biopsy. (c) CT scan shows wall thickening of the gastric antrum (white arrows) and several masses on the gastric wall (black arrows). (d) Photograph of the gastrectomy specimen reveals multiple masses in the body and antrum of the stomach (arrows), some of which have ulceration (arrowheads).

View larger version (155K): [in a new window]   Figure 9.   Transpyloric spread of a gastric adenocarcinoma in a 40-year-old man. Image from a double-contrast barium study shows diffuse thickening and irregularity of the mucosal folds in the antrum of the stomach (white arrows). Lobulated masses are seen in the duodenal bulb (black arrow). These lesions proved to be transpyloric spread of gastric adenocarcinoma at endoscopic biopsy.

View larger version (137K): [in a new window]   Figure 10a.   Early gastric carcinoma in a 59-year-old man. (a, b) Image from a double-contrast barium study (a) and CT scan obtained with water as an oral contrast agent (b) show a large polypoid lesion with a lobulated surface in the anterior wall of the proximal antrum (arrow). (c) Photograph of the gastrectomy specimen shows a polypoid lesion measuring 3.7 x 2.2 cm in the anterior wall of the gastric antrum (arrow). Surface lobulation is also noted. Histologic analysis revealed that the lesion was an adenocarcinoma confined to the mucosa and submucosa.

View larger version (169K): [in a new window]   Figure 10b.   Early gastric carcinoma in a 59-year-old man. (a, b) Image from a double-contrast barium study (a) and CT scan obtained with water as an oral contrast agent (b) show a large polypoid lesion with a lobulated surface in the anterior wall of the proximal antrum (arrow). (c) Photograph of the gastrectomy specimen shows a polypoid lesion measuring 3.7 x 2.2 cm in the anterior wall of the gastric antrum (arrow). Surface lobulation is also noted. Histologic analysis revealed that the lesion was an adenocarcinoma confined to the mucosa and submucosa.

View larger version (121K): [in a new window]   Figure 10c.   Early gastric carcinoma in a 59-year-old man. (a, b) Image from a double-contrast barium study (a) and CT scan obtained with water as an oral contrast agent (b) show a large polypoid lesion with a lobulated surface in the anterior wall of the proximal antrum (arrow). (c) Photograph of the gastrectomy specimen shows a polypoid lesion measuring 3.7 x 2.2 cm in the anterior wall of the gastric antrum (arrow). Surface lobulation is also noted. Histologic analysis revealed that the lesion was an adenocarcinoma confined to the mucosa and submucosa.

View larger version (138K): [in a new window]   Figure 11a.   Calcified mucinous adenocarcinoma of the stomach in a 62-year-old woman. (a) Image from a double-contrast barium study shows an encircling mass causing luminal narrowing in the gastric antrum (arrows). (b) CT scan obtained with water as an oral contrast agent shows wall thickening of the gastric antrum with diffuse low attenuation (curved arrow). Punctate calcifications (straight arrow) are noted within the thickened gastric wall.

View larger version (141K): [in a new window]   Figure 11b.   Calcified mucinous adenocarcinoma of the stomach in a 62-year-old woman. (a) Image from a double-contrast barium study shows an encircling mass causing luminal narrowing in the gastric antrum (arrows). (b) CT scan obtained with water as an oral contrast agent shows wall thickening of the gastric antrum with diffuse low attenuation (curved arrow). Punctate calcifications (straight arrow) are noted within the thickened gastric wall.