Gastric Carcinoma

gastric carcinoma

This female patient in her early fifites was being evaluated for malignant ascites. Oblique coronal curved reformatted CT image of the stomach shows focal wall thickening in the greater curvature with elevated mucosa and marked enhancement of the thickened inner layer of stomach wall. Some haziness is seen in the serosa with stranding in the adjacent omental fat suggesting transmural infiltration. Intraperitoneal fluid is seen around the liver.

Gastroduodenoscopy had shown a small raised friable mucosal lesion in the greater curvature of stomach. Biopsy showed undifferentiated adenocarcinoma.

With optimal gastric distension, the wall of the normal stomach is very thin and its folds become essentially effaced. On CT, gastric carcinomas may manifest as a focal area of mural thickening, as a polypoid lesion, or as generalized mural thickening.

In early gastric cancers, malignant invasion is limited to the mucosa or submucosa, regardless of the presence of lymph node metastases. The probability of transmural extension of the tumor is directly correlated with mural thickness. In transmural extension, the serosal contour becomes blurred and strandlike areas of increased attenuation may be seen extending into the perigastric fat. Advanced cancers can develop peritoneal metastases and ascites.

Ba-Ssalamah A, Prokop M, Uffmann M, et al. Dedicated multidetector CT of the stomach: Spectrum of diseases. RadioGraphics. 2003;23:625-644.

Credit: Dr Vijay Sadasivam