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Borrmann Type IV Gastric Cancer: Computed Tomography Features and Corresponding Pathological Findings.

Changfeng Ji1, Yi Ma1, Zhong Zheng2

  • 1From the Departments of Radiology.

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|October 6, 2023
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Summary

Computed tomography (CT) features correlate with pathological findings in Borrmann type IV (BT-4) gastric cancers. Understanding this association helps evaluate BT-4 gastric cancer aggressiveness.

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Area of Science:

  • Gastrointestinal radiology
  • Surgical pathology
  • Oncology imaging

Background:

  • Borrmann type IV (BT-4) gastric cancer is characterized by diffuse infiltration.
  • Distinct computed tomography (CT) features are observed in BT-4 gastric cancer.
  • The pathological basis for these CT features requires further elucidation.

Purpose of the Study:

  • To analyze the association between CT features and pathological findings in BT-4 gastric cancer.
  • To explore the pathological underpinnings of characteristic CT features in BT-4 gastric cancer.

Main Methods:

  • Retrospective analysis of 84 patients with BT-4 gastric cancer who underwent contrast-enhanced CT and surgical resection.
  • Evaluation of preoperative CT features including location, invasion, enhancement patterns, and lymph node status.
  • Correlation of CT findings with postoperative pathological results, including World Health Organization types, margins, organ invasion, and peritoneal status.

Main Results:

  • Poorly cohesive carcinoma was the most common World Health Organization type (65.5%), often showing circumferential invasion and layered enhancement.
  • While 97.6% of patients had positive lymph nodes, only 31.0% had enlarged nodes on CT.
  • Gastroesophageal junction lesions had higher positive margin rates; perigastric fat infiltration correlated with adjacent organ invasion; circumferential invasion was linked to peritoneal metastasis.

Conclusions:

  • Characteristic CT features of BT-4 gastric cancer are linked to underlying pathological findings.
  • Recognizing the CT-pathology association aids in assessing the aggressiveness of BT-4 gastric cancer.