Madhusudhan Kumble Seetharama, Das Prasenjit
Departments of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 10029, India.
Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 10029, India.
Abdom Radiol (NY). 2022 Jun;47(6):1988-2003. doi: 10.1007/s00261-022-03498-1. Epub 2022 Mar 26.
Mesenchymal tumors of the stomach are uncommon, with gastrointestinal stromal tumor (GIST) being the most common among them. Majority of the tumors may arise from cells of Cajal, smooth muscle cells, neural cells, totipotent stem cells, adipocytes or fibroblasts. Imaging plays an important role not only in staging but also in characterizing these tumors. Many of these tumors have characteristic imaging features. GISTs usually present as large cavitating and necrotic tumors with exophytic component. Presence of fat tissue within the tumor suggests a lipoma or a teratoma, early phase hyperenhancement indicates glomus tumor and hemangioma, and delayed contrast enhancement is seen in schwannoma. Their differentiation from epithelial tumors like carcinoma and neuroendocrine tumors is often possible based on the location (mesenchymal tumors are intramural), spread, morphological appearance and enhancement patterns. However, overlapping features exist between these tumors with imaging often being only suggestive. A biopsy is necessary for a definitive diagnosis in many cases.
胃间叶肿瘤并不常见，其中胃肠道间质瘤（GIST）最为常见。大多数肿瘤可能起源于 Cajal 细胞、平滑肌细胞、神经细胞、全能干细胞、脂肪细胞或成纤维细胞。影像学不仅在肿瘤分期中发挥重要作用，在肿瘤特征描述方面也很重要。这些肿瘤中的许多都有特征性的影像学表现。GIST 通常表现为具有外生性成分的大的空洞性坏死肿瘤。肿瘤内存在脂肪组织提示脂肪瘤或畸胎瘤，早期强化提示血管球瘤和血管瘤，而神经鞘瘤可见延迟强化。基于肿瘤位置（间叶肿瘤位于壁内）、扩散情况、形态外观和强化模式，通常可以将它们与上皮性肿瘤如癌和神经内分泌肿瘤区分开来。然而，这些肿瘤之间存在重叠特征，影像学表现往往只是提示性的。在许多情况下，活检对于明确诊断是必要的。
