Gastric Stromal Tumor and Primary Gastric Lymphoma:CT Imaging and Differential Diagnosis
10.3969/j.issn.1005-5185.2013.11.015
- VernacularTitle:胃间质瘤与原发性胃淋巴瘤的CT征象及鉴别诊断
- Author:
Tao LIU
;
Cunbao YANG
;
Jinglei LI
- Publication Type:Journal Article
- Keywords:
Gastrointestinal stromal tumors;
Stomach neoplasms;
Lymphoma;
Tomography,spiral computed;
Diagnosis,differential
- From:
Chinese Journal of Medical Imaging
2013;(11):849-852
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the CT findings of gastric stromal tumor (GST) and primary gastric lymphoma (PGL) for differential diagnosis. Materials and Methods The CT findings of 26 patients with GST confirmed pathologically and 21 patients with PGL confirmed pathologically were retrospectively analyzed with regards to location of lesion, number, range, relation between lesion and gastric wall, density, enhancement pattern, change of gastric mucoma and serous layer, and encroachment of perigastric lymph nodes and other organs. Results CT scans demonstrated that all 26 GST cases had single localized mass with relatively well-defined margin (17 cases located in gastric fundus, 9 cases inside stomach body) and that all 21 PGL cases showed single irregular diffused thickening of gastric wall, and most of which located in 2 or 3 parts with ill-defined margin. On plain CT scan, all lesions of GST appeared slightly hypo-density or iso-density, or heterogeneous density [mean CT value (32±11) Hu];while all lesions of PGL presented homogeneous iso-density [mean CT value (52±9) Hu] with statistical difference (t=12.37, P<0.05). On contrast enhanced scan, GST showed obvious homogeneous or heterogeneous delayed enhancement whereas PGL displayed slightly homogeneous delayed enhancement with statistical difference (t=5.35, P<0.05). Smooth and clear gastric mucosa was found in 26 GST cases without any perigastric lymph node enlargement. Two PGL cases had obscure gastric mucosa and the other 19 PGL cases showed smooth and clear gastric mucosa, 6 PGL cases with lymph node enlargement. Conclusion On CT scan, lesions of GST are limited, with heterogeneous density and obviously heterogeneous enhancement; whilst PGL has diffuse lesions, associated with homogenous density and slightly homogeneous enhancement. The different features are helpful in the diagnosis for both diseases.
