Computed tomography findings for a gastric lymphoepithelioma-like carcinoma: How often does it present as a submucosal mass?

To describe the anatomical location, size, tumour characteristics and morphology on CT of gastric lymphoepithelioma-like carcinoma (LELC) in order to determine the proportion of lesions that present as submucosal masses, and to review the clinicopathological findings. This retrospective study reviewed CT images of 186 lesions from 178 patients with LELC. CT morphologies and other findings were also analyzed. Pathology and medical records were reviewed. A pathology slide review of the lesions that presented with submucosal masses was performed. Gastric LELC presenting as a submucosal mass was found in 9.1 %. The most common CT morphology was eccentric wall thickening (67.7 %). On the pathology review, 14/17 submucosal mass lesions (82.4 %) had a central ulceration. 105 lesions were T1/T2 stage (94.1 %), and N0 stage was diagnosed in 66.1 %. Fifty-six of 63 metastatic lymph nodes (LNs) (88.9 %) demonstrated homogeneous enhancement, regardless of size. Male predominance (85.4 %), upper stomach location (45.7 %) and multiplicity (4.5 %) were found. Gastric LELC presenting as a submucosal mass is only detected in a small portion of all patients, and the most common finding is eccentric wall thickening. Central ulceration and enlarged LNs with homogeneous enhancement are occasionally other features on CT. (orig.)