Skip to main content

Advertisement

SpringerLink
Log in

The pediatric stomach — masses and mass-like pathology

  • Review
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Diagnostic imaging of pediatric gastric masses often provides a challenge for the practicing radiologist. Radiologists should be aware of this relatively unusual pathology, particularly in cross-sectional imaging findings. We will review pediatric gastric masses and mass-like lesions, focusing on neoplastic and inflammatory etiologies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13

Similar content being viewed by others

References

  1. Curtis JL, Burns RC, Wang L et al (2008) Primary gastric tumors of infancy and childhood: 54-year experience at a single institution. J Pediatr Surg 43:1487–1493

    Article  PubMed  Google Scholar 

  2. Iqbal CW, Mortellaro VE, Sharp SW et al (2012) Evaluation of ultrasonographic parameters in the diagnosis of pyloric stenosis. J Surg Res 47:1542–1547

    Google Scholar 

  3. Hernanz-Schulman M (2003) Infantile hypertrophic pyloric stenosis. Radiology 227:319–331

    Article  PubMed  Google Scholar 

  4. Menashe SJ, Iyer RS, Parisi MT et al (2017) Pediatric abdominal radiographs: common and less common errors. AJR Am J Roentgenol 209:417–429

    Article  PubMed  Google Scholar 

  5. Callahan MJ, Talmadge JM, MacDougall RD et al (2017) Selecting appropriate gastroenteric contrast media for diagnostic fluoroscopic imaging in infants and children: a practical approach. Pediatr Radiol 47:372–381

    Article  PubMed  Google Scholar 

  6. Hernanz-Schulman M, Goske MJ, Bercha IH, Strauss KJ (2011) Pause and pulse: ten steps that help manage radiation dose during pediatric fluoroscopy. AJR Am J Roentgenol 197:475–481

    Article  PubMed  Google Scholar 

  7. Atkinson NSS, Bryant RV, Dong Y et al (2017) How to perform gastrointestinal ultrasound: anatomy and normal findings. World J Gastroenterol 23:6931–6941

    Article  PubMed  PubMed Central  Google Scholar 

  8. Rapaccini GL, Aliotta A, Pompili M et al (1988) Gastric wall thickness in normal and neoplastic subjects: a prospective study performed by abdominal ultrasound. Gastrointest Radiol 13:197–199

    Article  CAS  PubMed  Google Scholar 

  9. Deslandes A (2013) Sonographic demonstration of stomach pathology: reviewing the cases. Australas J Ultrasound Med 16:202–209

    Article  PubMed  PubMed Central  Google Scholar 

  10. Paolantonio P, Rengo M, Ferrari R, Laghi A (2016) Multidetector CT in emergency radiology: acute and generalized non-traumatic abdominal pain. Br J Radiol 89:20150859

    Article  PubMed  PubMed Central  Google Scholar 

  11. Callahan MJ, Talmadge JM, MacDougall R et al (2016) The use of enteric contrast media for diagnostic CT, MRI, and ultrasound in infants and children: a practical approach. AJR Am J Roentgenol 206:973–979

    Article  PubMed  Google Scholar 

  12. Pickhardt PJ, Asher DB (2003) Wall thickening of the gastric antrum as a normal finding: multidetector CT with cadaveric comparison. AJR Am J Roentgenol 181:973–979

    Article  PubMed  Google Scholar 

  13. Desai RK, Tagliabue JR, Wegryn SA, Einstein DM (1991) CT evaluation of wall thickening in the alimentary tract. Radiographics 11:771–783

    Article  CAS  PubMed  Google Scholar 

  14. Callahan MJ, MacDougall RD, Bixby SD et al (2018) Ionizing radiation from computed tomography versus anesthesia for magnetic resonance imaging in infants and children: patient safety considerations. Pediatr Radiol 48:21–30

    Article  PubMed  Google Scholar 

  15. Darge K, Anupindi SA, Jaramillo D (2011) MR imaging of the abdomen and pelvis in infants, children, and adolescents. Radiology 261:12–29

    Article  PubMed  Google Scholar 

  16. Järvinen HJ, Sipponen P (1986) Gastroduodenal polyps in familial adenomatous and juvenile polyposis. Endoscopy 18:230–234

    Article  PubMed  Google Scholar 

  17. Islam RS, Patel NC, Lam-Himlin D, Nguyen CC (2013) Gastric polyps: a review of clinical, endoscopic, and histopathologic features and management decisions. Gastroenterol Hepatol 9:640–651

    Google Scholar 

  18. Attard TM, Yardley JH, Cuffari C (2002) Gastric polyps in pediatrics: an 18-year hospital-based analysis. Am J Gastroenterol 97:298–301

    Article  CAS  PubMed  Google Scholar 

  19. Feczko PJ, Halpert RD, Ackerman LV (1985) Gastric polyps: radiological evaluation and clinical significance. Radiology 155:581–584

    Article  CAS  PubMed  Google Scholar 

  20. Choe BK, Kim JY, Hwang JB et al (2006) A case of primary gastric lymphoma in a child. J Pediatr Hematol Oncol 28:296–299

    Article  PubMed  Google Scholar 

  21. Jacquemart C, Guidi O, Etienne I et al (2008) Pediatric gastric lymphoma: a rare entity. J Pediatr Hematol Oncol 30:984–986

    Article  PubMed  Google Scholar 

  22. Devaney K, Jaffe ES (1991) The surgical pathology of gastrointestinal Hodgkin’s disease. Am J Clin Pathol 95:794–801

    Article  CAS  PubMed  Google Scholar 

  23. Lin YM, Chiu NC, Li AF et al (2017) Unusual gastric tumors and tumor-like lesions: radiological with pathological correlation and literature review. World J Gastroenterol 23:2493–2504

    Article  PubMed  PubMed Central  Google Scholar 

  24. Miller FH, Kochman ML, Talamonti MS et al (1997) Gastric cancer. Radiologic staging. Radiol Clin N Am 35:331–349

    CAS  PubMed  Google Scholar 

  25. Ghai S, Pattison J, Ghai S et al (2007) Primary gastrointestinal lymphoma: spectrum of imaging findings with pathologic correlation. Radiographics 27:1371–1388

    Article  PubMed  Google Scholar 

  26. Derchi LE, Banderali A, Bossi C et al (1984) The sonographic appearances of gastric lymphoma. J Ultrasound Med 3:251–256

    Article  CAS  PubMed  Google Scholar 

  27. Vetro C, Romano A, Amico I et al (2014) Endoscopic features of gastro-intestinal lymphomas: from diagnosis to follow-up. World J Gastroenterol 20:12993–13005

    Article  PubMed  PubMed Central  Google Scholar 

  28. Mantese G (2019) Gastrointestinal stromal tumor: epidemiology, diagnosis, and treatment. Curr Opin Gastroenterol 35:555–559

    Article  CAS  PubMed  Google Scholar 

  29. Quiroz HJ, Willobee BA, Sussman MS et al (2018) Pediatric gastrointestinal stromal tumors—a review of diagnostic modalities. Transl Gastroenterol Hepatol 3:54

    Article  PubMed  PubMed Central  Google Scholar 

  30. Harlan LC, Eisenstein J, Russell MC et al (2015) Gastrointestinal stromal tumors: treatment patterns of a population-based sample. J Surg Oncol 111:702–707

    Article  PubMed  Google Scholar 

  31. Herzberg M, Beer M, Anupindi S et al (2018) Imaging pediatric gastrointestinal stromal tumor (GIST). J Pediatr Surg 53:1862–1870

    Article  PubMed  Google Scholar 

  32. Akram M, Ravikumar N, Azam M et al (2009) Prenatal findings and neonatal immature gastric teratoma. BMJ Case Rep. https://doi.org/10.1136/bcr.10.2008.1050

  33. Saleem M, Mirza B, Talat N, Sharif M (2018) Gastric teratoma: our 17 year experience. J Pediatr Surg 53:234–236

    Article  PubMed  Google Scholar 

  34. Kumar S, Yadav H, Rattan KN et al (2016) Immature gastric Teratoma in a newborn: a case report. J Neonatal Surg 5:21

    Article  PubMed  PubMed Central  Google Scholar 

  35. Tessler RA, Dellinger M, Richards MK et al (2019) Pediatric gastric adenocarcinoma: a National Cancer Data Base review. J Pediatr Surg 54:1029–1034

    Article  PubMed  Google Scholar 

  36. Lin CH, Lin WC, Lai IH et al (2015) Pediatric gastric cancer presenting with massive ascites. World J Gastroenterol 21:3409–3413

    Article  PubMed  PubMed Central  Google Scholar 

  37. Bulbul A, Fahy BN, Xiu J et al (2017) Desmoplastic small round blue cell tumor: a review of treatment and potential therapeutic genomic alterations. Sarcoma 2017:1278268

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  38. Morani AC, Bathala TK, Surabhi VR et al (2019) Desmoplastic small round cell tumor: imaging pattern of disease at presentation. AJR Am J Roentgenol 212:W45–W54

    Article  CAS  PubMed  Google Scholar 

  39. Dufresne A, Cassier P, Couraud L et al (2012) Desmoplastic small round cell tumor: current management and recent findings. Sarcoma 2012:714986

    Article  PubMed  PubMed Central  Google Scholar 

  40. Oguz B, Ozcan HN, Omay B et al (2015) Imaging of childhood inflammatory myofibroblastic tumor. Pediatr Radiol 45:1672–1681

    Article  PubMed  Google Scholar 

  41. Karnak I, Senocak ME, Ciftci AO et al (2001) Inflammatory myofibroblastic tumor in children: diagnosis and treatment. J Pediatr Surg 36:908–912

    Article  CAS  PubMed  Google Scholar 

  42. Patnana M, Sevrukov AB, Elsayes KM et al (2012) Inflammatory pseudotumor: the great mimicker. AJR Am J Roentgenol 198:W217–W227

    Article  PubMed  Google Scholar 

  43. Narla LD, Newman B, Spottswood SS et al (2003) Inflammatory pseudotumor. Radiographics 23:719–729

    Article  PubMed  Google Scholar 

  44. Kim SJ, Kim WS, Cheon JE et al (2009) Inflammatory myofibroblastic tumors of the abdomen as mimickers of malignancy: imaging features in nine children. AJR Am J Roentgenol 193:1419–1424

    Article  PubMed  Google Scholar 

  45. Hua MC, Kong MS, Lai MW, Luo CC (2007) Perforated peptic ulcer in children: a 20-year experience. J Pediatr Gastroenterol Nutr 45:71–74

    Article  PubMed  Google Scholar 

  46. Iwamuro M, Okada H, Matsueda K et al (2015) Review of the diagnosis and management of gastrointestinal bezoars. World J Gastrointest Endosc 7:336–345

    Article  PubMed  PubMed Central  Google Scholar 

  47. DuBose TM 5th, Southgate WM, Hill JG (2001) Lactobezoars: a patient series and literature review. Clin Pediatr 40:603–606

    Article  Google Scholar 

  48. Schreiner RL, Brady MS, Franken EA et al (1979) Increased incidence of lactobezoars in low birth weight infants. Am J Dis Child 133:936–940

    Article  CAS  PubMed  Google Scholar 

  49. Naik DR, Bolia A, Boon AW (1987) Demonstration of a lactobezoar by ultrasound. Br J Radiol 60:506–508

    Article  CAS  PubMed  Google Scholar 

  50. Goff WB 2nd, Kilcheski TS (1984) A gastric bezoar causing a target lesion as revealed by ultrasound. J Ultrasound Med 3:275–276

    Article  PubMed  Google Scholar 

  51. Ripollés T, García-Aguayo J, Martínez MJ, Gil P (2001) Gastrointestinal bezoars: sonographic and CT characteristics. AJR Am J Roentgenol 177:65–69

    Article  PubMed  Google Scholar 

  52. Gorter RR, Kneepkens CM, Mattens EC et al (2010) Management of trichobezoar: case report and literature review. Pediatr Surg Int 26:457–463

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Crowley E, Muise A (2018) Inflammatory bowel disease: what very early onset disease teaches us. Gastroenterol Clin N Am 47:755–772

    Article  Google Scholar 

  54. Mashako MN, Cezard JP, Navarro J et al (1989) Crohn’s disease lesions in the upper gastrointestinal tract: correlation between clinical, radiological, endoscopic, and histological features in adolescents and children. J Pediatr Gastroenterol Nutr 8:442–446

    Article  CAS  PubMed  Google Scholar 

  55. Pimentel AM, Rocha R, Santana GO (2019) Crohn’s disease of esophagus, stomach and duodenum. World J Gastrointest Pharmacol Ther 10:35–49

    Article  PubMed  PubMed Central  Google Scholar 

  56. Abdullah BA, Gupta SK, Croffie JM et al (2002) The role of esophagogastroduodenoscopy in the initial evaluation of childhood inflammatory bowel disease: a 7-year study. J Pediatr Gastroenterol Nutr 35:636–640

    Article  PubMed  Google Scholar 

  57. Ooi CJ, Makharia GK, Hilmi I et al (2016) Asia Pacific consensus statements on Crohn’s disease. Part 1: definition, diagnosis, and epidemiology. J Gastroenterol Hepatol 31:45–55

    Article  PubMed  Google Scholar 

  58. Farman J, Faegenburg D, Dallemand S, Chen CK (1975) Crohn’s disease of the stomach: the “ram’s horn” sign. AJR Am J Roentgenol 123:242–251

    Article  CAS  Google Scholar 

  59. Xiang H, Han J, Ridley WE, Ridley LJ (2018) Ram’s Horn Sign: Gastric antrum in Crohn's disease. J Med Imaging Radiat Oncol 62 Suppl 1:101

    Article  PubMed  Google Scholar 

  60. Mercado-Deane MG, Burton EM, Brawley AV, Hatley R (1994) Prostaglandin-induced foveolar hyperplasia simulating pyloric stenosis in an infant with cyanotic heart disease. Pediatr Radiol 24:45–46

    Article  CAS  PubMed  Google Scholar 

  61. Callahan MJ, McCauley RG, Patel H, Hijazi ZM (1999) The development of hypertrophic pyloric stenosis in a patient with prostaglandin-induced foveolar hyperplasia. Pediatr Radiol 29:748–751

    Article  CAS  PubMed  Google Scholar 

  62. Peled N, Dagan O, Babyn P et al (1992) Gastric-outlet obstruction induced by prostaglandin therapy in neonates. N Engl J Med 327:505–510

    Article  CAS  PubMed  Google Scholar 

  63. Strisciuglio C, Corleto VD, Brunetti-Pierri N et al (2012) Autosomal dominant Menetrier-like disease. J Pediatr Gastroenterol Nutr 55:717–720

    Article  PubMed  Google Scholar 

  64. Sferra TJ, Pawel BR, Qualman SJ, Li BU (1996) Menetrier disease of childhood: role of cytomegalovirus and transforming growth factor alpha. J Pediatr 128:213–219

    Article  CAS  PubMed  Google Scholar 

  65. Friedman J, Platnick J, Farruggia S et al (2009) Ménétrier disease. Radiographics 29:297–301

    Article  PubMed  Google Scholar 

  66. Sunkara T, Rawla P, Yarlagadda KS, Gaduputi V (2019) Eosinophilic gastroenteritis: diagnosis and clinical perspectives. Clin Exp Gastroenterol 12:239–253

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Mori A, Enweluzo C, Grier D, Badireddy M (2013) Eosinophilic gastroenteritis: review of a rare and treatable disease of the gastrointestinal tract. Case Rep Gastroenterol 7:293–298

    Article  PubMed  PubMed Central  Google Scholar 

  68. Koutri E, Papadopoulou A (2018) Eosinophilic gastrointestinal diseases in childhood. Ann Nutr Metab 73(Suppl 4):18–28

    Article  CAS  PubMed  Google Scholar 

  69. Licari A, Votto M, D’Auria E et al (2019) Eosinophilic gastrointestinal diseases in children: a practical review. Curr Pediatr Rev. https://doi.org/10.2174/1573396315666191022154432

  70. Brandon JL, Schroeder S, Furuta GT et al (2013) CT imaging features of eosinophilic colitis in children. Pediatr Radiol 43:697–702

    Article  PubMed  Google Scholar 

  71. Uppal V, Kreiger P, Kutsch E (2016) Eosinophilic gastroenteritis and colitis: a comprehensive review. Clin Rev Allergy Immunol 50:175–188

    Article  PubMed  Google Scholar 

  72. Savino A, Salvatore R, Cafarotti A et al (2011) Role of ultrasonography in the diagnosis and follow-up of pediatric eosinophilic gastroenteritis: a case report and review of the literature. Ultraschall Med 32:E57–E62

    Article  PubMed  Google Scholar 

  73. Horton KM, Corl FM, Fishman EK (1999) CT of nonneoplastic diseases of the small bowel: spectrum of disease. J Comput Assist Tomogr 23:417–428

    Article  CAS  PubMed  Google Scholar 

  74. Khanna G, Kao SC, Kirby P, Sato Y (2005) Imaging of chronic granulomatous disease in children. Radiographics 25:1183–1195

    Article  PubMed  Google Scholar 

  75. Marciano BE, Rosenzweig SD, Kleiner DE et al (2004) Gastrointestinal involvement in chronic granulomatous disease. Pediatrics 114:462–468

    Article  PubMed  Google Scholar 

  76. Kopen PA, McAlister WH (1984) Upper gastrointestinal and ultrasound examinations of gastric antral involvement in chronic granulomatous disease. Pediatr Radiol 14:91–93

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy St., Providence, RI, 02903, USA

    Michael S. Furman

  2. Department of Pediatric Radiology, Boston Children’s Hospital, Boston, MA, USA

    Susan A. Connolly, Stephen D. Brown & Michael J. Callahan

Authors
  1. Michael S. Furman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susan A. Connolly
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephen D. Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael J. Callahan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael S. Furman.

Ethics declarations

Conflicts of interest

None

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

CME activity

This article has been selected as the CME activity for the current month. Please visit the SPR website at www.pedrad.org on the Education page and follow the instructions to complete this CME activity.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Furman, M.S., Connolly, S.A., Brown, S.D. et al. The pediatric stomach — masses and mass-like pathology. Pediatr Radiol 50, 1180–1190 (2020). https://doi.org/10.1007/s00247-020-04697-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-020-04697-y

Keywords

Search

Navigation