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Gastric Carcinoma and Gastrointestinal Stromal Tumor
Fathima Fijula P. Manzil, MD; Paula Vergara-Wentland, MD; Paige Bennett, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Gastric carcinoma (GC)
              • Malignancy originating from glandular epithelium (adenocarcinoma) of gastric mucosa
              • Histologic types: Intestinal, diffuse, indeterminate types
            • Gastrointestinal stromal tumor (GIST)
              • Nonepithelial; arises from interstitial cells of Cajal
              • Most common mesenchymal neoplasm of GI tract
              • GISTs are potentially malignant
                • Lesions are stratified according to relative risk of recurrence and metastasis
                • Prediction of aggressive behavior (malignancy) is based on tumor size, site, mitotic rate (MR), and presence of metastasis
              • Pediatric GIST: Rare; have distinct clinical and pathologic features
            • Other gastric cancers: Gastric lymphoma (5%), carcinoid

          IMAGING

          • General Features

            • Nuclear Medicine Findings

              • CT Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Microscopic Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  Selected References

                                  1. Findlay JM et al: Routinely staging gastric cancer with 18F-FDG PET-CT detects additional metastases and predicts early recurrence and death after surgery. Eur Radiol. 29(5):2490-8, 2019
                                  2. Kwon Y et al: Preoperative assessment of malignant potential of gastrointestinal stromal tumor by dual-time-point 18F-fluorodeoxyglucose positron emission tomography imaging: usefulness of standardized uptake value and retention index. J Cancer Res Ther. 15(1):142-7, 2019
                                  3. Yoon JK et al: Clinicopathologic parameters associated with the FDG-avidity in staging of early gastric cancer using 18F-FDG PET. Medicine (Baltimore). 98(31):e16690, 2019
                                  4. Zhang S et al: Gastric ulcer mimicking malignancy on FDG PET/CT. Clin Nucl Med. 44(2):142-4, 2019
                                  5. Kaneko Y et al: Improving patient selection for 18F-FDG PET scanning in the staging of gastric cancer. J Nucl Med. 56(4):523-9, 2015
                                  6. Gastrointestinal stromal tumor. In Edge et al. AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer. 175, 2010
                                  7. Kochhar R et al: Imaging in gastrointestinal stromal tumours: current status and future directions. Clin Radiol. 65(8):584-92, 2010
                                  8. O'Sullivan PJ et al: The imaging features of gastrointestinal stromal tumours. Eur J Radiol. 60(3):431-8, 2006
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Definitions

                                            • Gastric carcinoma (GC)
                                              • Malignancy originating from glandular epithelium (adenocarcinoma) of gastric mucosa
                                              • Histologic types: Intestinal, diffuse, indeterminate types
                                            • Gastrointestinal stromal tumor (GIST)
                                              • Nonepithelial; arises from interstitial cells of Cajal
                                              • Most common mesenchymal neoplasm of GI tract
                                              • GISTs are potentially malignant
                                                • Lesions are stratified according to relative risk of recurrence and metastasis
                                                • Prediction of aggressive behavior (malignancy) is based on tumor size, site, mitotic rate (MR), and presence of metastasis
                                              • Pediatric GIST: Rare; have distinct clinical and pathologic features
                                            • Other gastric cancers: Gastric lymphoma (5%), carcinoid

                                          IMAGING

                                          • General Features

                                            • Nuclear Medicine Findings

                                              • CT Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Microscopic Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Consider

                                                                  Selected References

                                                                  1. Findlay JM et al: Routinely staging gastric cancer with 18F-FDG PET-CT detects additional metastases and predicts early recurrence and death after surgery. Eur Radiol. 29(5):2490-8, 2019
                                                                  2. Kwon Y et al: Preoperative assessment of malignant potential of gastrointestinal stromal tumor by dual-time-point 18F-fluorodeoxyglucose positron emission tomography imaging: usefulness of standardized uptake value and retention index. J Cancer Res Ther. 15(1):142-7, 2019
                                                                  3. Yoon JK et al: Clinicopathologic parameters associated with the FDG-avidity in staging of early gastric cancer using 18F-FDG PET. Medicine (Baltimore). 98(31):e16690, 2019
                                                                  4. Zhang S et al: Gastric ulcer mimicking malignancy on FDG PET/CT. Clin Nucl Med. 44(2):142-4, 2019
                                                                  5. Kaneko Y et al: Improving patient selection for 18F-FDG PET scanning in the staging of gastric cancer. J Nucl Med. 56(4):523-9, 2015
                                                                  6. Gastrointestinal stromal tumor. In Edge et al. AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer. 175, 2010
                                                                  7. Kochhar R et al: Imaging in gastrointestinal stromal tumours: current status and future directions. Clin Radiol. 65(8):584-92, 2010
                                                                  8. O'Sullivan PJ et al: The imaging features of gastrointestinal stromal tumours. Eur J Radiol. 60(3):431-8, 2006