4 X-ray morphologies of gastric lymphoma

Patients with gastric lymphoma may experience indigestion, nausea and vomiting. In severe cases, they may present with an obvious upper abdominal mass, which can cause serious symptoms. According to X-ray examination, the morphology of gastric lymphoma can be mainly divided into protruding type, ulcerative type, infiltrative type, diffuse infiltrative type, etc.

(1) Protruding type. Protruding type gastric lymphoma manifests as local protrusion under the mucosa. The gastric mucosal folds are often thickened, and the surface is usually intact. When the mass is large, the mucosa covering it is often edematous, eroded, or hemorrhagic, and the "cobblestone sign" often appears.

(2) Ulcerative type. The ulcerative type is the most common type of gastric lymphoma. The tumor is not obviously raised, with ulcers of varying sizes in the center, ranging from a few centimeters to more than ten centimeters in diameter. The bottom is uneven and may be covered with gray-yellow necrotic material. The edges are raised and hard, and the surrounding folds are thickened and coarsened in a radial pattern.

(3) Infiltrative type. Patients with infiltrative gastric lymphoma have submucosal infiltration of the gastric wall, with raised and folded mucosal folds, which may be localized or diffuse. The gastric mucosa is gyratory and the gastric wall is soft. As the disease progresses, the mucosa and the entire layer may be invaded, forming ulcers.

(4) Diffuse infiltrative type. Patients with diffuse infiltrative gastric lymphoma generally have thickened and hardened gastric walls, which often invade the entire stomach or most of the stomach. The degree of gastric stenosis is positively correlated with the degree of gastric wall stiffness, and may be accompanied by niches of varying depths.

Tips: Pebble sign

The cobblestone sign in patients with gastric lymphoma refers to irregular thickening of the gastric mucosal folds, multiple ulcers with irregular patterns, large folds formed in the mucosa at the edge of the ulcers, and single or multiple circular filling defects that appear similar to pebbles.