case_images: PMC2713837_01
case_images: Multiple myeloma with gastric involvement in a 61-year-old man.. A. Upper gastrointestinal series shows a large, protruding, luminal mass (arrows) with a well-defined margin in the anterior wall of the gastric cardia.. B. Contrast-enhanced CT scan demonstrates marked gastric wall thickening with subtle contrast enhancement (arrows).. C. Axial T2-weighted image shows homogeneous signal intensity slightly higher than that of the liver (arrows).. D. Axial gadolinium-enhanced MR image obtained 3 minutes after the administration of contrast material depicts homogeneous enhancement, similar to that of hepatic parenchyma.. E. Photograph of endoscopic biopsy specimen shows dense and monotonous infiltration by plasma cells (original magnification, x200; hematoxylin-eosin staining). Note the presence of a monomorphic population of plasma cells with variable atypia.
case_images: kjr-3-133-g001.jpg
case_images: PMC2713837_01_kjr-3-133-g001.jpg
case_images: F1
case_images: UGIS demonstrated a luminal protruding mass in the anterior wall of the gastric cardia and along the greater curvature of the body (Fig. 1A), while contrast-enhanced CT revealed marked thickening of the gastric wall, with subtle contrast enhancement (Fig. 1B). As demonstrated by T1-weighted imaging sequences, the signal intensity of the mass was less than that of the liver, though T2-weighting showed it as slightly higher, and homogeneous (Fig. 1C). After the administration of contrast material, the observed homogeneous enhancement was similar to that of hepatic parenchyma (Fig. 1D). Histopathologic examination revealed dense and monotonous infiltration by both mature and immature plasma cells (Fig. 1E), which at immunohistochemistry stained positive for IgG light chains.