Fistulating gastric B cell lymphoma
Weeks of LUQ pain with normal colonoscopy
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Markedly thickened gastric fundal wall with local perforation into a large LUQ mass incorporating the hemidiaphragm and spleen with a second splenic metastasis and local lymphadenopathy. Notice this mass contains oral contrast, gas and fluid ie from the gastric lumen. There is also pleural thickening on the left suggesting infiltration through the diaphragm inot the pleural space. A large ulcerated mass was confirmed at gastroscopy and B cell lymphoma diagnosed on histology.