Soft tissue uptake of Tc-99m labeled bone seeking agents, such as Tc-99m 3,3-diphosphono-1,2-propanedicarboxylic acid (DPD), is commonly seen in clinical practice, even though bone scintigraphy is mainly used to detect bone disease. However, gastric uptake of bone agents in patients with gastric cancer is very rare. And it has been reported that calcified gastric adenocarcinoma appears in only about 5% of all gastric cancer. We report a rare case of bone scintigraphy, single photon emission computed tomography and computed tomography fusion images that demonstrated diffuse gastric uptake of Tc-99m DPD in a patient with advanced gastric cancer.
Stomach Neoplasms/*metabolism ; Stomach/*metabolism ; Radiopharmaceuticals/*pharmacokinetics ; Organotechnetium Compounds/diagnostic use/*pharmacokinetics ; Male ; Humans ; Diphosphonates/diagnostic use/*pharmacokinetics ; Bone and Bones/*radionuclide imaging ; Aged

BACKGROUND/AIMS: This study evaluated the diagnostic efficacy of fluorine-18 fluorodeoxyglucose PET/CT (F-18 FDG PET/CT) for patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma and examined the association between FDG avidity and the clinical factors affecting lesions. METHODS: Among the patients diagnosed with gastric MALT lymphoma, 16 who underwent a PET/CT for gastric MALT lymphoma were semi-quantitatively and qualitatively tested for FDG avidity of lesions in the stomach. Retrospectively collected data was analyzed to investigate the clinicoradiological factors and endoscopic findings between the patients with positive F-18 FDG PET/CT scans and those with negative scans. RESULTS: Eight of the 16 patients showed FDG avidity. When comparing the size of lesions in the stomach, the patients with FDG avidity had significantly larger lesions than those without (28.8 mm vs. 15.0 mm, p=0.03). The FDG-avid group has a significantly higher rate of positive CT scans than the non-avid group (75% vs. 13%, p=0.03). According to the endoscopic finding of the lesions, FDG avidity was pronounced with 75% of the protruding tumors, and 100% of the erosive-ulcerative types, which are a type of depressed tumors. CONCLUSIONS: When gastric MALT lymphoma is large, when lesions are found using abdominal CT scans, and the macroscopic appearance of a lesion is that of a protruding tumor or erosive-ulcerative type of depressed tumor, there is a high probability that such patients may have a positive F-18 FDG PET/CT scan.
Aged ; Female ; Fluorodeoxyglucose F18/chemistry/metabolism ; Gastroscopy ; Humans ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/diagnostic imaging ; Male ; Middle Aged ; Positron Emission Tomography Computed Tomography ; Retrospective Studies ; Stomach Neoplasms/diagnostic imaging/metabolism

BACKGROUNDMany studies have shown that cancer cell differentiation and microvascular invasion play a principle role in cancer progression and metastasis, and non-invasive imaging techniques such as CT, MRI and US assessing the differentiation and the surgical resectibility and the prognosis of cancers are now of great importance. This study aimed to explore the correlation of triple-phase multi-slice CT scan with the histological differentiation and intratumor microvascular/lymphatic invasion of progressive gastric cancer.

METHODSThe present study included 64 patients with gastric cancer, all of whom underwent routinal and dual-phase contrast enhancement multi-slice CT examinations of the upper abdomen before surgery. The post-operative specimens were used for determination of histological differentiation, cancer cell invasion of intratumoral microvascular/lymphatic vessel identified by CD34 and D2-40 expression. Correlations between contrast enhancement ratio (CER) of triple-phase multi-slice CT scan in gastric cancer and histological differentiation as well as intratumoral microvascular/lymphatic invasion were compared and analyzed.

RESULTSThere was a significant correlation between CER of triple-phase CT scan in gastric cancer and tumor histological differentiation (P < 0.05). CER of the arterial phase in gastric cancer with intratumoral microvascular invasion was significantly higher than that without invasion (0.61 ± 0.28 vs. 0.46 ± 0.14, P < 0.05); CER of the arterial-parenchymal phase was significantly lower in gastric cancer with intratumoral microvascular invasion than that without invasion (1.81 ± 0.39 vs. 2.28 ± 0.80, P < 0.05). However, CER of the parenchymal phase in gastric cancer with intratumoral lymphatic invasion was significantly higher than that without invasion (1.25 ± 0.57 vs. 1.00 ± 0.35, P < 0.05).

CONCLUSIONSCER of triple-phase multi-slice CT scan in gastric cancer is closely correlated with intratumoral microvascular and lymphatic invasion, and also could be used as a marker for histological differentiation.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Immunohistochemistry ; In Vitro Techniques ; Lymphatic Metastasis ; diagnostic imaging ; Male ; Middle Aged ; Stomach Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Tomography, X-Ray Computed ; methods

BACKGROUNDThis study aimed to investigate multi-slice CT contrast-enhanced presentation of gastric cancer and its correlation with histo-differentiation and p53 and P-glycoprotein (P-gp) expression.

METHODSSixty-six patients with gastric cancer in the present study underwent a multi-slice CT preoperative routine and dual-phase contrast-enhanced examination of the upper abdomen; postoperative specimens were used to determine histo-differentiation and the expression of p53 and P-gp. The correlation of multi-slice CT contrast-enhanced presentation with histo-differentiation and expression of p53 and P-gp was analyzed.

RESULTSThe dual-phase contrast-enhanced ratio (CER) was not correlated with the histo-differentiation of gastric cancer (P > 0.05). Positive expression of p53 and P-gp was significantly higher in the cases of layered or heterogeneous enhancement than in the cases of homogenous enhancement (P < 0.05). Positive expression of p53 was also correlated with the arterial phase CER, tumor size and lymph node metastasis (P < 0.05), but not with infiltration thickness of the gastric wall, nor was it correlated with the portal phase CER (P > 0.05). Positive expression of P-gp was only correlated with the portal phase CER (P = 0.005).

CONCLUSIONSDifferently enhanced pattern and CER of the arterial and portal phase in gastric cancer correlate with its different histo-differentiation and expression of p53 and P-gp respectively. In addition, tumor size and lymph node metastasis of gastric cancer relate to the expression of p53.

ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Stomach Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Tomography, X-Ray Computed ; methods ; Tumor Suppressor Protein p53 ; metabolism

OBJECTIVETo establish experimental models for tumor neovascularization and to apply quantitative digital imaging analysis in the study.

METHODSAn endothelial tube formation model was established by human umbilical vein endothelial cells (HUVECs). A vasculogenic mimicry model was established by SGC-7901 gastric cancer cell line. Fertilized eggs were used to establish a chorioallantoic membrane angiogenesis model. Using gene transfection experiment, IRX1 tumor suppressor gene was chosen as a therapeutic target. Image Pro Plus (IPP) analysis software was used for digital vascular images analysis with parameters including points, lines, angles and integral absorbance (IA) for the tubular formation or vasculogenic mimicry.

RESULTSDigital image analysis by IPP showed that HUVEC tubular formation was significantly inhibited in IRX1 transfectant, compared with controls. The tubular numbers in three groups were 12.80 +/- 3.83, 29.00 +/- 5.34 and 28.20 +/- 4.32 (P<0.01). The connection points of tubules in three groups were 13.20 +/- 2.59, 25.00 +/- 2.24 and 24.60 +/- 3.21 (P<0.01). The tubular lengths of three groups were (821.5 +/- 12.5), (930.9 +/- 13.5) and (948.4 +/- 18.1) microm (P=0.022). The IA values of PAS stain in three groups were 3606 +/- 363, 14 200 +/- 1251 and 15 043 +/- 1220 (P<0.01). In chick chorioallantoic membrane model, the angular numbers of tubules in three groups were 6.41 +/- 2.60, 10.27 +/- 2.65 and 9.18 +/- 1.99 (P<0.01).

CONCLUSIONSThe endothelial tube formation model, vasculogenic mimicry model and chorioallantoic membrane angiogenesis model are useful for gene therapy and drug screening with targeting neoplastic vascularization. Professional image analysis software may greatly facilitate the quantitative analysis of tumor neovascularization.

Animals ; Cell Line, Tumor ; Cells, Cultured ; Chorioallantoic Membrane ; blood supply ; Diagnostic Imaging ; methods ; Homeodomain Proteins ; genetics ; metabolism ; physiology ; Human Umbilical Vein Endothelial Cells ; Humans ; Neovascularization, Pathologic ; Neovascularization, Physiologic ; Software ; Stomach Neoplasms ; genetics ; metabolism ; pathology ; Transcription Factors ; genetics ; metabolism ; physiology ; Transfection

OBJECTIVETo study the relationship between spiral CT findings and histological differentiation and expressions of p53 and Ki67 in gastric carcinoma.

METHODSTriphasic spiral CT was performed in 158 patients. CT findings included maximal diameter and thickness of tumor in three dimensional CT images, degree of enhancement, mucous situation, lymph nodes, and visceral metastasis were recorded. The expressions of p53 and Ki67 were detected with immunohistochemistry and reverse transcription polymerase chain reaction.

RESULTSThe thickness of tumor (chi2 = 5.554, P = 0.018), degree of enhancement (chi2 = 4.978, P = 0.026), and lymph nodes metastasis (chi2 = 6.061, P = 0.014) in the three dimensional CT images were significantly correlated with tumor histological differentiation. Lymph nodes metastasis was significantly correlated with the expression of p53 (chi2 = 5.028, P = 0.025). The expression of Ki67 was significantly correlated with the thickness of tumor (chi2 = 5.674, P = 0.017) and lymph nodes metastasis (chi2 = 5.028, P = 0.025).

CONCLUSIONMulti-slice CT is a simple and noninvasive technique, and can be used for assessing the histological differentiation of gastric cancer as well as the expressions of p53 and Ki67 before the operation.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Stomach Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Tomography, Spiral Computed ; Tumor Suppressor Protein p53 ; metabolism ; Young Adult

Spontaneous gastric perforation is a rare complication of gastric lymphoma that is potentially life threatening since it can progress to sepsis and multi-organ failure. Morbidity also increases due to prolonged hospitalization and delay in initiating chemotherapy. Therefore prompt diagnosis and appropriate treatment is critical to improve prognosis. A 64-year-old man presented to the emergency department with severe abdominal pain. Chest X-ray showed free air below the right diaphragm. Abdominal CT scan also demonstrated free air in the peritoneal cavity with large wall defect in the lesser curvature of gastric lower body. Therefore, the patient underwent emergency operation and primary closure was done. Pathologic specimen obtained during surgery was compatible to diffuse large B cell lymphoma. Fifteen days after primary closure, the patient received subtotal gastrectomy and chemotherapy was initiated after recovery. Patient is currently being followed-up at outpatient department without any particular complications. Herein, we report a rare case of gastric lymphoma that initially presented as peritonitis because of spontaneous gastric perforation.
Abdominal Pain ; Antigens, CD20/metabolism ; Antigens, CD45/metabolism ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Gastrectomy ; Humans ; Intestinal Perforation/diagnostic imaging ; Lymphoma, Large B-Cell, Diffuse/*diagnosis/drug therapy/pathology ; Lymphoma, Non-Hodgkin/*diagnosis/drug therapy/pathology ; Male ; Middle Aged ; Positron-Emission Tomography ; Stomach Neoplasms/*diagnosis/drug therapy/pathology ; Tomography, X-Ray Computed