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Primary Extrapulmonary Small Cell Carcinoma Involving the Stomach or Duodenum or Both: Findings on CT and Barium Studies

Seung Soo Lee1, Hyun Kwon Ha1, Ah Young Kim1, Tae Kyoung Kim1, Pyo Nyun Kim1, Eunsil Yu2, Moon-Gyu Lee1, Seung-Jae Myung3, Hwoon-Yong Jung3, Jin Ho Kim3 and Young Il Min3

1 Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnapdong, Songpa-gu, Seoul, 138-736, Korea.
2 Department of Diagnostic Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea.
3 Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea.



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  		Fig. 1A. —62-year-old man with small cell carcinoma of stomach. Barium study shows well-circumscribed mass (arrows) with central ulceration (arrowheads) on greater curvature side of gastric antrum.

 


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  		Fig. 1B. —62-year-old man with small cell carcinoma of stomach. Contrast-enhanced CT scan shows poorly enhanced mass (arrows) in antrum and adjacent dumbbell-shaped exophytic mass (M).

 


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  		Fig. 2A. —58-year-old man with small cell carcinoma of stomach. Contrast-enhanced CT scan shows exophytic gastric mass (arrows) with central ulceration (U).

 


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  		Fig. 2B. —58-year-old man with small cell carcinoma of stomach. Photograph of resected specimen shows gastric mass (arrows) with central ulceration (U).

 


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  		Fig. 3A. —72-year-old man with small cell carcinoma of stomach and duodenum. Barium study shows ulcerated, filtrative mass (arrows) involving prepyloric antrum and first portion of duodenum.

 


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  		Fig. 3B. —72-year-old man with small cell carcinoma of stomach and duodenum. Contrast-enhanced CT scan shows poorly enhanced mass (arrows) encircling duodenum with moderately enhanced internal septalike structures. Duodenal lumen is narrowed by mass.

 


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  		Fig. 3C. —72-year-old man with small cell carcinoma of stomach and duodenum. Photomicrograph of histopathologic specimen shows hyperchromatic viable tumor cells (T) in background of necrosis (n). Fibrovascular septa (arrows) in tumor are possibly responsible for CT finding of moderately enhancing septalike structure in poorly enhanced mass. (H and E, x40)

 


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  		Fig. 4A. —59-year-old woman with small cell carcinoma of periampullary duodenum. Contrast-enhanced CT scan shows dilatation of intrahepatic bile duct. Metallic suture materials are seen at gastrojejunostomy site.

 


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  		Fig. 4B. —59-year-old woman with small cell carcinoma of periampullary duodenum. Contrast-enhanced CT scan shows poorly enhanced mass (asterisk) bulging into periampullary duodenum.

 


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  		Fig. 4C. —59-year-old woman with small cell carcinoma of periampullary duodenum. Percutaneous transhepatic cholangiogram shows dilatation of common bile duct and round filling defect in periampullary duodenum (arrows).

 

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