Learning Radiology xray montage

Gastric Lymphoma

• Comprises 3-5% of all gastric neoplasms

• Non-Hodgkin’s accounts for 80% of all gastric lymphomas

• Begins in the submucosa

• Most occur in distal body and antrum of stomach

• Almost all gastric lymphoma presents with some degree of ulceration

Frequency of GI occurrence by site (of all lymphomas)

     • Stomach

     • Small intestine

     • Rectum

     • Rest of colon

Lymphosarcoma of the Stomach

     • Suggested by the relatively younger age at presentation than ca

    • Suggested by the extent of the lesions radiographically-multiple ulcers, irregular masses, widespread infiltration

     • May be associated with involvement of the bowel elsewhere—e.g. duodenum, cecum or rectosigmoid and mesenteric masses


      Nodular—single or multiple intragastric masses, easily confused with ca, protrude into the lumen, often with multiple ulcerations

    Polypoid—barium in interstices, frequently with ulceration; sometimes resembles metastatic disease such as melanoma

      Ulcerative—shallow, saucer-like ulcer indistinguishable from ca

       Infiltrative—thickened, irregular folds, simulating the appearance of hypertrophic gastritis; about 10% present this way

 CT Staging

             • Stage I          tumor confined to bowel wall

             • Stage II        limited to local nodes

             • Stage III       widespread nodal disease

             • Stage IV       bone marrow, liver, other organs

 DDX-Linitis plastica

      • Carcinoma

      • Lymphoma

      • Gastritis, e.g. phlegmonous, eosinophilic, postradiation

      • Granulomatous, e.g. Crohn’s, sarcoid, TB

      • Syphilis

      • Amyloidosis