Presentation
Abdominal pain and vomiting. There is also history of anorexia, fever and weight loss.
Patient Data
Age: 45 years
Gender: Male
From the case:
Gastric lymphoma
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- Marked circumferential thickening of body, antrum and pylorus of the stomach with significant luminal narrowing. No clear planes seen between the lesion and pancreatic head and transverse colon.
- A few focal hepatic lesions and an enhancing lesion in either kidney.
- Small left adrenal adenoma, mesenteric congestion, multiple mesenteric soft tissue nodules, moderate abdominopelvic ascites, multiple left para-aortic lymph nodes, simple cortical cyst at the upper pole of left kidney, recent post-surgical changes in the left inguinal region with suspicion of recurrent hernia and mild left pleural effusion.
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Interval improvement noted in the gastric, hepatic and renal lesions. Interval improvement also noted in the mesenteric findings. Stable left adrenal lesion and ascites. Mildly distended proximal colon without any obvious focal colonic mass lesion. Bilateral pleural effusions.
From the case:
Gastric lymphoma
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Endoscopic biopsy of the gastric lesion=Large cell type non-Hodgkin lymphoma (NHL).
Case Discussion
- Marked circumferential mural thickening of the stomach; gastric lymphoma ? other possible differentials are gastrointestinal stromal tumor (GIST) and gastric adenocarcinoma.
- A few focal hepatic and bilateral enhancing renal lesions, which are likely lymphomatous or metastatic deposits.
- Follow up scan showed marked interval improvement in the gastric lesion. Hepatic and renal lesions were likely lymphomatous deposits as these lesions also showed significant interval improvement.