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DOI: 10.1148/radiol.2312030248
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(Radiology 2004;231:421-426.)
© RSNA, 2004

Gastrointestinal Imaging

Scirrhous Gastric Carcinoma: Endoscopy versus Upper Gastrointestinal Radiography1

Mi-Suk Park, MD, Hyun Kwon Ha, MD, Byung Se Choi, MD, Kyoung Won Kim, MD, Seung-Jae Myung, MD, Ah Young Kim, MD, Tae Kyoung Kim, MD, Pyo Nyun Kim, MD, Nam-Ju Lee, MD, Jeong Kyung Lee, MD, Moon-Gyu Lee, MD and Jin Ho Kim, MD

1 From the Departments of Diagnostic Radiology (M.S.P., H.K.H., B.S.C., K.W.K., A.Y.K., T.K.K., P.N.K., N.J.L., J.K.L., M.G.L.) and Internal Medicine (S.J.M., J.H.K.), Asan Medical Center, University of Ulsan College of Medicine, 388–1 Poongnap Dong, Songpa-Ku, Seoul 138–040, South Korea; and Department of Diagnostic Radiology, YongDong Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (M.S.P.). Received February 24, 2003; revision requested May 16; final revision received September 16; accepted September 29. Address correspondence to H.K.H. (e-mail: hkha@www.amc.seoul.kr).

PURPOSE: To compare the accuracy of upper gastrointestinal (UGI) series and endoscopic examination in the diagnosis and localization of scirrhous gastric carcinoma.

MATERIALS AND METHODS: Seventy-two patients with pathologically proved scirrhous gastric carcinoma in surgical specimens were included. Preoperative reports at UGI series and endoscopic examination, which included impressions on the location and extent of the tumor, were compared with pathology reports, and the accuracy of the preoperative reports was calculated. Two gastrointestinal radiologists retrospectively reviewed the appearance of mucosa at UGI series.

RESULTS: Preoperative diagnoses at endoscopy were Borrmann type IV carcinoma in 28 patients (39%), type III carcinoma in 29 (40%), early gastric carcinoma in seven (10%), lymphoma in six (8%), atrophic gastritis in one (3%), and type II carcinoma in one (3%). Preoperative diagnoses at UGI series were type IV carcinoma in 44 patients (61%), type III carcinoma in 25 (35%), lymphoma in two (3%), and early gastric carcinoma in one (1%). Pathology reports were compared with the preoperative reports, and tumor location and extent were correct in the endoscopic examination reports of 24 patients (33%) and the UGI series reports of 49 patients (68%). In 68 patients, UGI series revealed thickened and irregular folds in 62 (91%), ulceration in 42 (62%), and nodularity in 22 (32%) at consensus review. Endoscopic biopsy samples were positive for malignancy in 66 patients (93%).

CONCLUSION: UGI series is superior to endoscopic examination in the diagnosis and localization of scirrhous gastric carcinoma.

© RSNA, 2004

Index terms: Endoscopy, 72.123 • Gastrointestinal tract, radiography, 72.1231 • Stomach, neoplasms, 72.321




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