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figure 30.4. Malignant gastric GIST in a 49-year-old man. (A) Axial CT of the abdomen with oral and intravenous contrast reveals an exophytic mass arising from the posterior aspect of the stomach (arrow) and extending along the gastrosplenic ligament. Note marked thickening of the gastric mucosal folds posteriorly. (B) Axial CT of the abdomen at a level lower than (A) reveals extensive central necrosis and a cavity (arrow) that is air filled. The mass invades the wall of the transverse colon (arrowhead).

figure 30.4. Malignant gastric GIST in a 49-year-old man. (A) Axial CT of the abdomen with oral and intravenous contrast reveals an exophytic mass arising from the posterior aspect of the stomach (arrow) and extending along the gastrosplenic ligament. Note marked thickening of the gastric mucosal folds posteriorly. (B) Axial CT of the abdomen at a level lower than (A) reveals extensive central necrosis and a cavity (arrow) that is air filled. The mass invades the wall of the transverse colon (arrowhead).

mas, and neurofibromas. The imaging features of these tumors may be similar to GISTs. Gastric adenocarcinoma and lymphoma may also have a radiologic appearance similar to GISTs. However, they rarely demonstrate large exophytic growth, and when advanced are commonly associated with bulky adenopa-thy, a feature that is not seen in malignant GISTs.

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