Primary gastric lymphoma

Case contributed by Dr Vitalii Rogalskyi

Presentation

Epigastric pain, nausea, weight loss.

Patient Data

Age: 60 years
Gender: Male
CT

Initial CT

CT of the abdomen demonstrates marked stomach wall thickening with a great extension and relatively homogeneous enhancement. Surrounding fat seems to be intact. Some small perigastric lymph nodes noted.

Endoscopic biopsy was performed. Lab answer: diffuse large B-cell lymphoma. 

Patient has had several cycles of chemotherapy.

CT

CT: 4 months later

Visible reduction of stomach wall thickening. No perigastric lymph nodes.

Annotated image

The images show good response of gastric lymphoma to chemotherapy.

Case Discussion

This case demonstrates primary gastric lymphoma. On initial CT we have DDX list with lymphoma and gastric carcinoma with prevalence of first one because of:

  • too marked wall thickening without perigastic fat infiltration or signs of nearby organs invasion
  • great lesion extension along the stomach
  • small homogeneous regional lymph nodes
  • no visible metastasis.

Diffuse large B-cell gastric lymphomas are treated with chemotherapy with a good response.

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Case information

rID: 66355
Published: 17th Feb 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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