[Gastric tumors with fatty components. CT findings and differential diagnosis].
OBJECTIVE
To assess the role of CT in diagnosing and characterizing gastric fatty tumors.


METHODS
We reviewed the CT scans of 16 patients (8 men, 8 women, mean age 52 years) with gastric fatty tumors (11 lipomas, 3 liposarcomas, 1 angiolipoma, 1 teratoma) examined from 1990 to 1999. The differential diagnosis considered primary and secondary lipomatosis, carcinoma engulfing the perivisceral fat and thus mimicking a liposarcoma, mesenchymal gastric and primary peritoneal tumors.


RESULTS
Lipomas involved the fundus (7/11), the body (3/11), the antrum (1/11). Multifocality was found in one case. Lesions size ranged 25 to 65 mm (mean 35 mm). All the lipomas showed homogeneous structure with negative (-30 -100) HU values. A pseudocapsule was demonstrated in 7/11 cases. No infiltrative growth was demonstrated. The angiolipoma located in the fundus showed a vascular component with strong contrast enhancement. All the liposarcomas were bigger than 10 cm and there was a strong correlation between pathologic specimen and CT findings. The differentiated liposarcomas showed the classic heterogeneous fatty density; on the contrary the myxoid and the pleomorphic types showed an aspecific structure with necrotic/cystic changes, mostly demonstrated in the myxoid type. The teratoma was a solid mass with fatty, solid, necrotic and calcified components.


CONCLUSIONS
CT allows the diagnosis and characterization of gastric fatty tumors. The preoperative diagnosis of lipomas plays a major clinical role because it often makes surgery unnecessary.
Ferrozzi
F
F
Istituto di Scienze Radiologiche, Università degli Studi, Parma. ferrozzi@unipr.it
Tognini
G
G
Marchesi
G
G
Spaggiari
E
E
Pavone
P
P
D000328:Adult; D018206:Angiolipoma / Q000000981:diagnostic imaging; D002277:Carcinoma / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008067:Lipoma / Q000000981:diagnostic imaging; D008080:Liposarcoma / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018205:Neoplasms, Adipose Tissue / Q000000981:diagnostic imaging*; D011859:Radiography; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging*; D013724:Teratoma / Q000000981:diagnostic imaging
Tumori gastrici con componente adiposa. Aspetti con Tomografia Computerizzata e diagnostica differenziale.