CASE 141

History: A 41-year-old man presents with dyspepsia and diarrhea.

1. What should be included in the differential diagnosis of the imaging finding shown in Figure A? (Choose all that apply.)

A. Lymphoma

B. Stromal tumor

C. Infective gastritis

D. Hypertrophic gastritis

E. Zollinger-Ellison syndrome (ZES)

2. What is the most common location of extrapancreatic gastrinomas?

A. Para-aortic retroperitoneum

B. Urinary bladder

C. Duodenum

D. Ovaries

3. Besides multiple ulcers, what is another common presentation of gastrinomas?

A. Weight loss

B. Heartburn

C. Vomiting

D. Diarrhea

4. Which of the following statements regarding gastrinomas is true?

A. The most sensitive test for the diagnosis of a gastrinoma is elevation of the fasting serum gastrin above the normal value of 150 pg/mL.

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