Small Submucosal Tumors of the Stomach: Differentiation of Gastric Schwannoma from Gastrointestinal Stromal Tumor with CT.
10.3348/kjr.2012.13.4.425
- Author:
Jin Wook CHOI
1
;
Dongil CHOI
;
Kyoung Mee KIM
;
Tae Sung SOHN
;
Jun Haeng LEE
;
Hee Jung KIM
;
Soon Jin LEE
Author Information
1. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea. dichoi@skku.edu
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Gastrointestinal submucosal tumor;
Schwannoma;
Submucosal tumor;
Gastric tumor;
Stomach;
CT
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Contrast Media/diagnostic use;
Diagnosis, Differential;
Endoscopy, Gastrointestinal;
Female;
Gastrointestinal Stromal Tumors/pathology/*radiography;
Humans;
Iohexol/analogs & derivatives/diagnostic use;
Logistic Models;
Male;
Middle Aged;
Neurilemmoma/pathology/*radiography;
Retrospective Studies;
Statistics, Nonparametric;
Stomach Neoplasms/pathology/*radiography;
Tomography, X-Ray Computed/*methods
- From:Korean Journal of Radiology
2012;13(4):425-433
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. MATERIALS AND METHODS: We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. RESULTS: Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). CONCLUSION: Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.
