Gastric splenosis mimicking a gastrointestinal stromal tumor: A case report

Table 1 Characteristics of intramural gastric masses

	Location in the stomach	CT special features	Special features
Benign lesions
Lipoma[19]	Antrum	Attenuation values -70 HU to -120 HU	Solitary, fibrous capsulated, soft (change in size and shape with peristalsis), no vessels
Leiomyoma[24]	Cardia	Low attenuation, endoluminal growth pattern	Negative for c-kit, positive for desmin and smooth muscle actin
Schwannoma[21]	Body	Minimal enhancement on the arterial phase	Absence of calcification, hemorrhage, necrosis; not encapsulated; positive for S-100
Glomus tumor[20]	Antrum	Strong enhancement on early-phase	Highly vascular; positive for calponin and smooth muscle actin
Inflammatory fibroid polyp[22]	Antrum	Enhancement on arterial phase	Positive for CD34 and vimentin
Hemangioma[25]	-	Strong enhancement on early-phase	Phleboliths are pathognomonic
Plexiform fibromyxoma[23]	Antrum	Myxoid tissue interspersed with vessels	Unique to the stomach, size from 2 cm to 15 cm
Ectopic pancreas[26]	Greater curvature	Similar to normal pancreas	-
Splenosis[5]	-	Enhancement on arterial phase	Splenectomized patients
Malignant lesions
GIST[18]	Body	Smoothly circumscribed, bullseye sign	Positive for c-kit or dog-1; 50% greater than 2 cm
Non-GIST sarcoma (liposarcoma, leiomyosarcoma, unclassified sarcoma)[27]	-	Usually large, heterogeneous enhancement	Positive for desmin and smooth muscle actin, negative for c-kit
Lymphoma[33]	-	Wall thickening	Distant (more than close) and large adenopathy
Carcinoid[29]	-	Multiple small lesions	Reactive to synaptophysin and chromogranin A, hypergastrinemia related symptoms
Inflammatory myofibroblastic tumor[28]	-	Heterogeneously enhancing tumor (malignant appearance)	Borderline tumor, more frequent in young adults and children; reactivity for ALK
Metastasis[30-32]	-	-	“Homomorphic” endoscopic features; dyschromic lesions

CT: Computed tomography; GIST: Gastrointestinal stromal tumor; ALK: Anaplastic lymphoma kinase.