Gastric adenoma with atypical appearance: findings on double-contrast barium study with histopathologic correlation

Abdom Imaging. 2000 Mar-Apr;25(2):124-8. doi: 10.1007/s002619910029.

Abstract

Background: To describe the radiologic findings of nonpolypoid gastric adenomas and to correlate them with pathologic findings.

Methods: During a 9-year period, we reviewed 49 pure gastric adenomas in 43 patients with positive radiologic findings. Of these adenomas, seven with atypical polypoid appearance were retrospectively included in the study. We reviewed these findings with double-contrast barium study and correlated them with the pathologic findings.

Results: Of seven nonpolypoid adenomas, four were depressed and three were flat at pathologic examination. All were diagnosed as early gastric carcinoma (five as type IIc, one as type IIb, one as type IIa + IIc) in upper gastrointestinal series. Three were located in the gastric angle, two in the lower body, and two in the antrum. Size ranged from 10 mm to approximately 25 mm (mean = 15 mm). Six lesions had nodular surface and five had convergency of the mucosal folds. A shallow depressed area was seen in six lesions.

Conclusions: A considerable proportion of gastric adenomas presents as a depressed or flat lesion on double-contrast barium study because of histologic characteristics of decreased subjacent mucosa. Because the nonpolypoid adenoma has a greater potentional for malignancy, more precaution is needed during the follow-up of this uncommon lesion.

MeSH terms

  • Adenoma / diagnostic imaging*
  • Adenoma / pathology
  • Adenomatous Polyps / pathology
  • Aged
  • Barium Sulfate*
  • Carcinoma / pathology
  • Contrast Media*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Retrospective Studies
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / pathology

Substances

  • Contrast Media
  • Barium Sulfate