Bull's-eye lesions: A new gastrointestinal presentation of mastocytosis

Abstract

Systemic mastocytosis is a rare disorder that infrequently affects the GI tract. Bowel involvement in mastocytosis is characterized by thickened folds and small mucosal nodules, and there is an increased incidence of peptic ulcer disease and malabsorption. This paper describes a new case of mastocytosis that presented radiographically as 1.0-1.5 cm gastric and duodenal nodules. Some of the duodenal nodules were bull's-eye lesions with central collections of barium. Mastocytosis, along with primary neoplasms, aberrant pancreas, eosinophilic granuloma, and metastases should be included in the differential for bull's-eye lesions of the GI tract.

Systemic mastocytosis involving the gastrointestinal tract: clinicopathologic and molecular study of five cases

“…Such nodularity has been documented by others, both radiologically and endoscopically. 2,[6][7][8]18,19,23,[34][35][36][37][38] Other nonspecific findings seen in this series and reported in the literature include erosions, loss of mucosal folds and friability. A substantial proportion of cases shows no obvious endoscopic or radiological abnormality.…”

“…30,32 While all patients in our series were women, the literature indicates an equal sex distribution for systemic mastocytosis in general 33 and for those cases with direct gastrointestinal involvement. [5][6][7][8][9][10][11]13,[16][17][18][19][21][22][23]31 Endoscopically and grossly, the most frequent and distinctive finding in our series was that of mucosal nodularity (present in four of five patients). Such nodularity has been documented by others, both radiologically and endoscopically.…”

Systemic Mastocytosis: Radiological Point of View

“…However, the most important imaging features are 1) diffuse thickening and dilation of the stomach, small and large bowel with nonocclusive strictures, 2) gastric, duodenal, and small-bowel thickened folds, 3) mucosal nodular or polypoid lesions, and 4) organomegaly. 39 Thickened folds are due to mast cell proliferation in the lamina propria. Several mucosal nodules are “target” or “bull’s-eye” lesions with a central collection of contrast agents on barium examinations.…”