Gastric adenocarcinoma

Gastrointestinal:
The stomach is markedly abnormal, with a large polypoid low density mass projecting into the lumen along the lesser curvature of the stomach. There is similar appearance of heterogeneous low-density along the posterior fundus region.

There are numerous enlarged lymph nodes, some of which demonstrate heterogeneous low-density that is suggestive of central necrosis. The lymph nodes surround the stomach, the majority centered in the gastrohepatic space, although there are multiple additional abnormal lymph nodes along the greater curvature at the mid to distal gastric body. There is stranding within the omentum surrounding the stomach and abnormal lymph nodes. There are additional abnormal lymph nodes within the periportal, peripancreatic, portacaval space as well as within the upper abdominal mesentery. Finally, there are nodules and stranding noted in the gastrosplenic ligament with small nodules extending into the splenic hilum.

There are numerous ill-defined hypoenhancing liver lesions with some demonstrating subtle peripheral enhancement predominantly within the right hepatic lobe. The largest of which is a lesion in segment 5 of the liver measuring 1.8 cm.

Bones:
There is extensive, diffuse small sclerotic bony lesions throughout all the visualized bones including the thoracic spine, lumbar spine, pelvic bones and hips, as well as the ribs. The partially visualized sternum and scapula also demonstrate sclerotic bony lesions.

GU:
There is marked right-sided hydronephrosis with abrupt tapering at the right proximal ureter where there is ill-defined high density soft tissue. There is a delayed right nephrogram, moderate perinephric fluid/stranding, and urothelial thickening/enhancement throughout the renal pelvis.

There are indeterminant bilateral adrenal nodules with mild surrounding stranding.