PMC5002114_01
Initial abdominal ultrasound (cat). Transmural thickening (about 9 mm) of the gastric body wall with loss of normal wall layering
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Fig1
Abdominal ultrasound showed a hypoechoic transmural thickening (approximately 9 mm) at the gastric body, associated with loss of normal wall layering and hyperechoic speckles possibly consistent with focal fibrosis (Fig. 1).
Initial endoscopy of the stomach (cat). Tumour-like gastric mass with an ulcerated depression at the level of the greater curvature between the fundus and gastric body
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Fig2
Endoscopic examination of the stomach showed a gastric mass with an ulcerated depression at the level of the greater curvature between the fundus and gastric body (Fig. 2).
Second endoscopy of the stomach (cat). Performed 2 months after the initial endoscopy, shows the presence of a large whitish thickened mucosal area with a central part covered by fibrin at the level of the greater curvature in front of the pyloric antrum, indicating a healing phase ulcer
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Fig3
Endoscopic examination identified a large whitish, thickened mucosal area, the central region of which appeared to be covered by fibrin at the level of the greater curvature in front of the pyloric antrum, ascribable to pseudomembranous plaque, without evidence of an ulcer (Fig. 3).
Gastric wall. Gram staining showing filamentous Gram-positive bacteria (arrow)
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Fig4
Gram-staining and ZN-staining, in order to potentially identify organisms not previously observed in histopathologic sections. Gram-positive filamentous organisms were visible in multiple microscopic fields consistent with Actinomyces spp. (Fig. 4). 
Third abdominal ultrasound (cat). Performed 4 months post-surgery, shows a complete healing of the gastric lesion with normal thickness and normal layering of the gastric wall
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Fig5
Abdominal ultrasound identified complete resolution of the gastric lesion with normal thickness and almost normal layering of gastric wall (Fig. 5).
Third abdominal ultrasound (cat). Performed 4 months post-surgery, evidences a focal asymmetric hypoechoic thickening with loss of normal layering of the jejunal wall
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Fig6
In one loop the wall measured 6.7 mm, for a length of approximately 3.2 cm (Fig. 6), and in the other the wall measured 3.1 mm, extending for a length of approximately 2 cm.