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Figure 2a. Diffuse large B-cell lymphoma of the stomach in an 81-year-old man who presented with epigastric pain. (a) Spot radiograph from an upper gastrointestinal study shows a mass with luminal narrowing in the gastric antrum and deep ulceration in the inferior wall (arrow). Other nodules of various sizes (arrowhead) are seen adjacent to the mass. (b) Contrast-enhanced CT scan shows diffuse, homogeneous gastric antral wall thickening with a lobulated inner surface and a smooth well-defined outer wall (arrowheads). (c) High-power photomicrograph (original magnification, x600; hematoxylineosin [H-E] stain) shows a large blast cell infiltrate (short arrow) extending around epithelial glands (arrowhead). Mitoses, an important feature of high-grade tumors, are clearly seen (long arrow). (d) High-power photomicrograph (original magnification, x600; immunohistochemical stain CAM5.2) shows the destruction of epithelial glands by infiltrating blast cells (arrow). Brown areas represent cytokeratin.
