FDG-avid antrum-pylorus ulcer, adjacent lymph node, and abdominal wall nodule mimicking gastric cancer with metastases

Dan Ruan, MD; Yanhong Wang, MM; Janyao Fang, MM; Xinyu Teng, MM; Beilei Li, MD, PhD

Radiology Case Reports (May 2022)

FDG-avid antrum-pylorus ulcer, adjacent lymph node, and abdominal wall nodule mimicking gastric cancer with metastases

Dan Ruan, MD,
Yanhong Wang, MM,
Janyao Fang, MM,
Xinyu Teng, MM,
Beilei Li, MD, PhD

Affiliations

Dan Ruan, MD: Department of Nuclear Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, Fujian, 361015, China
Yanhong Wang, MM: Department of Nuclear Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, Fujian, 361015, China
Janyao Fang, MM: Department of Nuclear Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, Fujian, 361015, China
Xinyu Teng, MM: Department of Nuclear Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, Fujian, 361015, China
Beilei Li, MD, PhD: Department of Nuclear Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, Fujian, 361015, China; Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 20032, China; Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China; Corresponding author.

Journal volume & issue: Vol. 17, no. 5
pp. 1396 – 1401

Abstract

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Gastric cancer presents with similar clinical symptoms as gastric ulcer, and the morphologic features of gastroscopy overlap considerably. We report a 58-year-old man with the clinical presentation of recurrent gastric discomfort and black stools. A suspected malignant tumor of the gastric antrum-pylorus was observed on gastroscopy. Contrast-enhanced CT showed enhancement of the lesion. PET/CT revealed an FDG-avid lesion at the gastric antrum-pylorus, an intense FDG-uptake perigastric lymph node, and an enlarged nodule with high FDG uptake in the right abdominal wall. Subsequent surgical pathology revealed an inflammatory ulcer of the gastric antrum-pylorus with reactive hyperplastic lymph node, while the lesion in the right abdominal wall was a scar nodule. This case suggests that when multiple FDG-avid lesions accompany an atypical gastric ulcer, it can easily lead to misdiagnosis, and therefore more emphasis should be placed on histopathological analysis.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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