Transpyloric spread of gastric tumors: Comparison of adenocarcinoma and lymphoma

OBJECTIVE. Our objective was to determine the relative frequency of transpyloric tumor spread in gastric antral carcinoma and lymphoma. MATERIALS AND METHODS. We reviewed the medical records of 127 cases of pathologically proven gastric malignant tumors, including 102 carcinomas and 25 lymphomas, over a 10-year period. The antrum had carcinoma in 64 cases and lymphoma in 15, We reviewed upper gastrointestinal barium studies and correlated the findings of transpyloric tumor extension with the results of surgery, pathology, and endoscopy. RESULTS. Tumor extension into the duodenal bulb occurred in 15 (25%) of 64 patients with carcinoma and in six (40%) of 15 patients with lymphoma of the gastric antrum. Transpyloric spread of antral carcinoma as revealed by barium study was much more common in our series than has been stated in the literature. CONCLUSION. Duodenal invasion of an antral carcinoma is not rare. Because of the higher incidence of carcinoma, transpyloric spread of gastric tumor as revealed by barium studies should not by itself suggest the diagnosis of lymphoma.