case_images: PMC7381218_01
case_images: Pathology and imaging data of patient 1. (A) The CT of the patient at the first examination; (B) The gastroscopic pathology that suggested adenocarcinoma of the gastric body. (C) The CT of the patient after four cycles of combined chemotherapy. (D) Postoperative pathology of the patient.
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case_images: Enhanced CT of the whole abdomen and pelvis in July 2017 suggested diffuse thickening of the gastric wall, considering the leather stomach with lymph node metastasis in the hepatogastric space (Figure 1A). Gastroscopic pathology revealed adenocarcinoma of the gastric body and Helicobacter pylori (+) (Figure 1B). Imaging showed that the scope of gastric malignant tumor was significantly smaller than that at the first diagnosis (Figure 1C), and the gastric minor curvature and hepatogastric interspace lymph nodes were significantly smaller than those at the first diagnosis. Postoperative pathology revealed diffuse poorly differentiated adenocarcinoma of the gastric body, 6 x 4 cm in size, invading the subserosa, upper and lower margin was negative with pericardial lymph nodes (1/14), lesser curved gastric lymph nodes (7/13), and suprapyloric lymph nodes (1/1) (Figure 1D).
case_images: PMC7381218_02
case_images: Pathology and imaging data of patient 2. (A) The CT of the patient at the first examination; (B) The gastroscopic pathology that suggested gastric poorly differentiated adenocarcinoma with abdominal lymph node metastasis; (C) PET-CT after four cycles of combined chemotherapy showed no focal increase in FDG in local gastric wall of gastric cardia and fundus; (D) Postoperative pathology of the patient.
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case_images: Enhanced CT of the whole abdomen and pelvis in April 2018 revealed thickening of the cardia and stomach floor, multiple enlarged lymph nodes around the abdominal trunk, and consideration of gastric cancer (Figure 2A). The pathological diagnosis was gastric poorly differentiated adenocarcinoma with abdominal lymph node metastasis (Figure 2B). PET-CT scan was performed to observe the treatment (Figure 2C). PET-CT showed thicker local gastric wall of gastric cardia and fundus, no focal increase in FDG metabolism, and no increase in FDG metabolism of small perigastric lymph nodes. The pathological stage was ypT2N0M0 (Figure 2D).
case_images: PMC7381218_03
case_images: Pathology and imaging data of patient 3. (A) The CT of the patient at the first examination; (B) The gastroscopic pathology that adenocarcinoma of the lesser curvature of the gastric body; (C) Enhanced CT scan was performed, suggesting that the tumor was further smaller than first examination; (D) Postoperative pathology of the patient.
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case_images: The enhancement CT of whole abdomen and pelvis in March 2017 showed that the local gastric wall of the gastric body was thickened, about 13 mm at the thickest point, with obvious enhancement, and lymph nodes seemed to be shown around it (Figure 3A). Pathology revealed adenocarcinoma of the lesser curvature of the gastric body (Figure 3B). When the patient completed four cycles of combined chemotherapy, an enhanced CT scan was performed to observe the treatment (Figure 3C), suggesting that the tumor was further smaller than the third cycle, and the efficacy evaluation was PR. The pathological stage is ypT1N1M0 (Figure 3D).