Gastric lymphoma

Case contributed by Michael P. Hartung
Diagnosis certain

Presentation

Withheld.

Patient Data

Age: 70 years
Gender: Male
ct

Small pericardial effusion with nodules. 

Diffuse soft tissue thickening of the stomach without obstruction. 

Small retroperitoneal mass inferior to the left kidney. 

Right orchiectomy due to lymphoma. Heterogeneous left testicle possibly involved. 

Few small nodules in the left medial gluteal and thigh subcutaneous tissues. 

Nuclear medicine

Fused PET/CT with many sites of active disease. 

Pericardial uptake.

Gastric lymphoma and left retroperitoneal lesions are very FDG avid.

Multiple FDG avid subcutaneous, muscular, and bone lesions. 

Left testicular uptake. 

Case Discussion

Highlights:

  • Typical features of gastric lymphomatous infiltration, with diffuse soft tissue thickening without obstruction 
  • Retroperitoneal deposit inferior to the left kidney is a good reminder to look for unexpected sites of disease, and also keep lymphoma on the differential for unusual cases
  • Very aggressive disease with numerous small subcutaneous and muscular lesions. Many are relatively subtle on CT, but very apparent on PET/CT

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