PMC3552783_01
Pre-treatment endoscopic examination shows a large bleeding mass in the small curvature of the stomach
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The biochemical tests were; blood urea nitrogen (BUN):29 mg/dL (9-23), creatinin:0,85 mg/dL (0.7-1.23), potassium (K): 4,6 mg/dL (3.5-5.5), calcium (Ca): 8,1 mg/dL (8.3-10.6), LDH:284 U/L (120-246), AST: 19 U/L (0-34), ALT: 9 U/L (10-49), ALP: 64 U/L (45-129), GGT: 101U/L (0-73). The upper gastrointestinal endoscopic examination revealed a bleeding ulcerative lesion with a diameter of 2 cm in the small curvature of the stomach (Figure 1).
Image of gastric glands in lamina propria infiltrated by plasma cells (H&E section; 400x magnification)
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Biopsy of the gastric lesion showed neoplastic plasma cells, monoclonal lambda light chain positive, infiltrating gastric mucosa (Figure 2).
Lambda positive staining of gastric glands in lamina propria (H&E section; 400x magnification)
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Kappa negative staining of gastric glands in lamina propria (H&E section; 400x magnification)
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Pre-treatment PET-CT scan of the patient. PET images show presence of intense FDG uptake (SUVmax 26.5) in the gastric curvatures with thickening
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The scan showed dense FDG uptake (suv max: 26,5) in gastric fundus and corpus with a wall thickness of 35 mm (Figure 5).
Post-treatment endoscopic screening shows no residual tumor mass
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After the chemotherapy, control upper gatrointestinal endoscopy was performed and found that the lesion was completely resolved. (Figure 6).
Post-treatment PET-CT scan showing no residual mass in the abdomen
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PET-CT scan to determine the last status of the lesions in the body. PET-CT scan showed no residual lesion in whole body and. showed a dramatic shrinkage of the gastric mass (Figure 7) also shown in PET-CT fusion images (Figures 8 and 9).
Pre and post-treatment PET fusion images of the patient. The dramatic shrinkage of the gastric mass is exactly shown between the images
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PET-CT scan to determine the last status of the lesions in the body. PET-CT scan showed no residual lesion in whole body and. showed a dramatic shrinkage of the gastric mass (Figure 7) also shown in PET-CT fusion images (Figures 8 and 9).