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Morphologically
carcinoma of the stomach may present as an intraluminal polyp,
ulcerative lesion or infiltrative scirrhous lesion.
Scirrhous
carcinomas typically cause irregular narrowing and rigidity of
the stomach, giving rise to the typical linitis plastica, or leather-bottle
appearance.
Sonography :
Demonstrate the presence of an intraluminal mass, focal
or diffuse wall thickening and/or an exophytic mass. A target or atypical target sign may be present. An atypical target sign corresponds more frequently
to adenocarcinoma while a typical target sign due to more uniform
diffuse involvement is more common with lymphomas.
The presence of ascites in association with a stomach mass
is strongly suggestive of peritoneal metastases.
Some tumors present a high echogenic dot with an acoustic
shadow, which bas been interpreted as an ulcer in the center of
the tumor.
Differential
: Causes of a thickened gastric wall :
*Tumors - benign and malignant (primary or secondary).
*Lymphoma.
*Gastritis
*Artificial (peristalsis),
*Peptic ulceration.
*Portal hypertension gastropathy.
*Varioliform gastritis.
*Focal foveolar hypertrophy.
*Ménétrier's disease.
*Hypertrophic pyloric stenosis.
*Lymphoid hyperplasie.
*Henoch-Schônlein purpura.
*Chronic granulomatous disease of childhood.
*Haematoma - particularly post-endoscopy.
*Crohn's disease.
*Gastric amyloidosis.
*Interstitial emphysema.
*Ectopic pancreas.
*Gastric sarcoidosis.
*Gastric tuberculoses.
*Chemical agents and toxins - ingestion of acid, alkali, iron,
etc.
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