Hyperrugosity in gastric carcinoma: radiographic, endoscopic, and pathologic features.

The morphology of the rugal folds in carcinoma of the stomach is reviewed, with emphasis on the hyperrugosity of the diffusely infiltrating lesions. Six of the 27 patients with diffuse infiltrating lesions demonstrated atypical features and were misdiagnosed as benign gastropathies or lymphomas. In these six patients there was enlargement, irregularity, and tortuosity of the rugal folds with the preservation of a relatively normal gastric volume, distensibility, and peristaltic activity. The involvement was segmental or diffuse and ulcerations were observed on endoscopic and radiographic examinations in two of the cases. Deep endoscopic biopsies were successful in establishing a correct diagnosis in most of the cases. The pathologic correlation, pitfalls in the radiologic and endoscopic diagnosis, and a short review of the pertinent literature are presented.