A 35 year-old male came to E.R due to melena lasting for 3 days
Considering the imaging finding of circumferential wall thickening of gastric body with no sign of obstruction
The first impression was gastric lymphoma
But, If the lesion is lymphoma, the absence of lymphadenopathy is not common.
physician’s impression was gastric lymphoma > AGC B2 or GIST
Endoscopic biopsy was done, the pathologic result was ‘Poorly cohesive carcinoma’
It was advanced gastric cancer…!
In this case, it was difficult to differentiate because it showed both gastric lymphoma and gastric carcinoma characteristics. It is good to remember the differentiation point in Imaging finding between gastric lymphoma and gastric carcinoma. Check the short review below.
Short reivew) Gastric lymphoma vs gastric adenocarcinoma
Gastric lymphoma
- Marked thickening of stomach wall (2~4cm) with lateral extension along the wall of stomach
- Extensive local nodal enlargement – Common
- Gastric outlet obstruction or perigastric fat invasion – Uncommon
Gastric carcnoma
- Relatively focal wall involvement than gastric lymphoma
- Lymph nodes tend to be smaller and more localized to immediate draining nodes
- Gastric outlet obstruction or perigastric fat invasion – Common
