确诊GIST，胃里有1个4.1cm肿块 确诊GIST，寻找病因，以及治疗方案和费用 - 图文问诊

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CT CHEST/ABDOMEN/PELVIS W C + 3D - Details Study Result Narrative INDICATION: Proximal gastric mass for staging. COMPARISON: None available. TECHNIQUE: Axial CT images of the thorax, abdomen, and pelvis was performed with multiplanar reformats. IV contrast was administered. FINDINGS: CT thorax: The central tracheobronchial tree is patent. No pleural effusions. No focal groundglass or dense airspace opacities. 0.3 cm groundglass opacity within the left lower lobe, image 81, series 204. 0.2 cm subpleural nodule within the right lower lobe, image 65. Right lower lobe subpleural nodule measuring 0.3 cm, image 90. 0.6 cm perifissural/subpleural right upper lobe nodule, image 62. No significant axillary, supraclavicular, mediastinal, or hilar lymphadenopathy. Residual thymic tissue. No central pulmonary emboli. No pericardial effusions. No mid or distal paraesophageal lymphadenopathy. No acute fractures or destructive bone lesions involving the thoracic cage. CT abdomen and pelvis: There is a soft tissue density mass centered within the posterior aspect of the gastric fundus/cardia measuring approximately 3.8 x 4.1 x 4.1 cm, best seen on image 114, series 201 and image 76, series 202. I suspect the mass is predominantly submucosal extending to the serosal margin. However, there is mucosal irregularity as seen on image 71, series 202. No discrete extension beyond the serosal margin. Suspicious locoregional gastrohepatic lymph node measuring up to 1.0 cm in short axis diameter, image 114, series 201. The gastroesophageal junction appears spared, best appreciated on image 68, series 202. The more distal aspect of the stomach is unremarkable. No small bowel obstruction. Colon is unremarkable. Normal appendix. No ascites. No peritoneal nodularity or omental thickening. Hypoattenuation along the falciform ligament, some of which is likely related to focal fat deposition. However there is a more rounded hypoenhancing focus within segment IVb measuring 1.5 x 1.5 cm, best seen on

患者

best seen on image 124, series 201 and image 41, series 202. No other focal liver lesions identified. The spleen, adrenals, pancreas, gallbladder, and biliary tree are unremarkable. No focal renal lesions. No hydronephrosis. No perinephric stranding. No ureteric calculi. Bladder is thin walled. Prostate is normal size. No retroperitoneal lymphadenopathy. Portal vein is patent. No AAA. No acute fractures or destructive bone lesions involving the lumbosacral spine. OPINION: 1. 4.1 cm proximal gastric fundal/cardia mass within associated enlarged gastrohepatic lymph node. This is highly concerning for an underlying gastric malignancy such as adenocarcinoma or possible GIST. Indeterminate lesion adjacent to the falciform ligament of the liver, which may represent a more rounded area of focal fat deposition, however underlying mass cannot be excluded and further assessment with MRI is recommended. 2. Bilateral nonspecific subcentimeter lung nodules. Short-term follow-up CT thorax examination is recommended in 3 months to reassess. Component Results There is no component information for this result.

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抱歉也是帮忙问，上面是CT报告

患者

Component Results Component ADDENDUM Your Value Part C: As per guideline for counting mitotic figures in gastrointestinal stromal tumors, a total count of mitosis per 5 mm2 is required. This will ideally be done on the resection specimen. The current biopsy is composed of multiple fragments and therefore it is challenging to count the mitotic figures in a 5 mm2 area; however, as per request of responsible clinician the mitotic figures were counted in a mitotically active area. There are 13 mitotic figures within an area of approximately 1 mm2. This was reviewed with a second pathologist. A. Antrum, Biopsy: -Antral type mucosa within normal limits -Special stain for Helicobacter pylori organisms is negative B. Stomach Body, Biopsy: -Body type mucosa within normal limits -Special stain for Helicobacter pylori organisms is negative C. Fundal Mass, Biopsy: -Gastrointestinal stromal tumor (GIST) -See comment Standard Flag Range FINAL DIAGNOSIS COMMENT Sections in part C show numerous fragments of gastric mucosa with a submucosal proliferation of a mixture of epithelioid and spindle cells. These cells demonstrate high N/C ratio and hyperchromatic nuclei. Mitotic figures are readily apparent. Upon immunohistochemistry, the cells of interest are diffusely and strongly positive for DOG1, CD117, and, CD34. They are negative for AE1/AE3, CK7, CK20, SMA, S100, and, CD45. Special stain for Helicobacter pylori organisms is negative. Overall findings are those of a gastrointestinal stromal tumor (GIST) which is present at the biopsy edges. This case was reviewed within the department with consensus. Pre-op Diagnosis: Abdominal symptoms Post-op Diagnosis: R19.8 - Abdominal symptoms Specimens: A) - Antrum, Biopsy B) - Stomach Body, Biopsy C) - Fundal Polyp, fundul mass CLINICAL INFORMATIO N CASE REPORT GROSS DESCRIPTIO N A) Antrum, Biopsy: The specimen container is labeled antrum, biopsy. Received in formalin are 2 fragments of tan soft ti

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A) Antrum, Biopsy: The specimen container is labeled antrum, biopsy. Received in formalin are 2 fragments of tan soft tissue ranging in size from 0.2-0.3 cm in maximum dimension. The specimen is entirely submitted for microscopy in block A1. B) Stomach Body, Biopsy: The specimen container is labeled stomach body, biopsy. Received in formalin are 2 fragments of tan soft tissue ranging in size from 0.2-0.4 cm in maximum dimension. The specimen is entirely submitted for microscopy in block B1. C) Fundal Polyp: fundul mass The specimen container is labeled fundal polyp (fundul mass). Received in formalin are multiple fragments of tan soft tissue ranging in size from 0.1-0.4 cm in maximum dimension. The specimen is entirely submitted for microscopy in block C1.

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您如果还需要别的资料我再去问

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非常感谢🙏您辛苦了

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上面是CT的照片

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