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

Objectives: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
Key Points: • LELCs as submucosal masses on CT were detected in only 9.1 %. • The most common CT finding was eccentric wall thickening (67.7 %). • Central ulceration and enlarged LNs with homogeneous enhancement might be seen.