2017-08-10 13:59:43 UTC

Submucosal Tumor of the Stomach With Drastic, Short-Term Changes in Morphology

Aug. 10, 2017

What caused the lesion in a man diagnosed with a submucosal tumor in the upper gastric corpus, to change to a reddish, semipedunculated tumor with blood oozing on the surface?

Gastroenterology Clinical Image Challenge: A 47-year-old man was referred to our institution for a detailed examination of a gastric tumor. One year previously, the patient was diagnosed as having a submucosal tumor in the upper gastric corpus by screening esophagogastroduodenoscopy (Figure A). On admission, laboratory tests were within normal limits and Helicobacter pylori was negative as determined by the stool antigen test and the serological test. Esophagogastroduodenoscopy revealed that the lesion had increased in size with ulceration (Figure B). Repeated biopsies from the lesion failed to achieve a definitive histopathological diagnosis. One month later, the lesion had changed to a reddish, semipedunculated tumor with blood oozing on the surface (Figure C). Endoscopic ultrasound examination showed that the tumor was located mostly in the submucosal layer (Figure D). Computed tomography depicted a well-circumscribed tumor in the stomach, which was enhanced with contrast medium, without any metastatic lesions.

What is the diagnosis?

To find out the diagnosis, read the full case in Gastroenterology or download our Clinical Image Challenge app through AGA App Central, which features new cases each week. Sort and filter by organ, most popular or favorites. AGA App Central is available in both the Apple App Store and Google Play.

More on Helicobacter pylori Infection

Effects of Community Screening for Helicobacter pylori: 13-Year Follow-Up Evaluation of a Randomized Controlled Trial

Oct. 22, 2017

This randomized clinical trial with 13 years of follow-up evaluation, designed to provide evidence on the effect of H pylori population screening, showed no significant long-term effect when compared with usual care in this low-prevalence area.

Initiation and Maintenance of Gastric Cancer: A Focus on CD44 Variant Isoforms and Cancer Stem Cells

July 1, 2017

Cell surface adhesion molecule CD44 has been identified as a gastric cancer stem cell marker.

Clinical Manifestations of Helicobacter pylori–Negative Gastritis

June 22, 2017

We found that H pylori–negative gastritis was present in approximately 18% of patients with gastritis.