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The CT demonstrates uniform thickening of the gastric wall consistent with an inflammatory process. There is exquisite mucosal and serosal enhancement and submucosal low attenuation. These are the signs of florid active inflammatory change. This extends into the duodenal bulb but not beyond this. There is a large gastric residue evident. There does not appear to be any disruption to the structure of the gastric wall. There was no significant lymphadenopathy. There was no imaging evidence for recurrence of the bladder tumour. A barium follow through examination showed persisting barium residue in the stomach on later films, despite barium distally in the ileum and an empty/collapsed duodenum, …
One year after this initial presentation, this gentleman developed symptoms of colonic inertia. Western blot was negative for paraneoplastic markers (anti-Hu, Ri, Ma, Yo, CV2/CRMPS and amphiphysin antibodies). Immunochemistry demonstrated nuclear staining of Purkinje cells and brainstem neurons. A repeat chest x ray demonstrated a large mediastinal mass (not evident a year previously). Histology has confirmed a diagnosis of malignant thymoma. This ascociation has not been previously reported.
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