Transpyloric Extension to Duodenal Bulb in Gastric Lymphoma

Gastric lymphoma may present in a spectrum of morphologic patterns which may mimic a variety of diseases clinically, endoscopically, radiologically and surgically. From its common location within the gastric antrum, transpyloric submucosal spread frequently occurs to involve the duodenal bulb and occasionally the proximal descending duodenum. This distinctive pathologic characteristic results in contour deformities, filling defects, and ulcerations of the duodenum which can be traced in continuity from the gastric lesions. These radiological observations are significant in the preoperative diagnosis of primary malignant lymphoma of the stomach and in the evaluation of disseminated lymphoma.