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FIGURE 4. Example of diffuse gastric localization on SRS in patient with ZES without MEN-1 or gastric carcinoid. Coronal view (A) and transverse view (B) of SRS showed diffuse uptake in stomach. This patient had ZES of 11 y duration, and mean fasting serum gastrin level was 2900 pg/mL (normal level is <200 pg/mL). Upper gastrointestinal endoscopic findings were unremarkable except for prominent gastric folds. Histology of 2 random Jumbo Cup biopsy (Pauldrach) samples from gastric body on greater curvature showed moderate linear hyperplasia of ECL cells with dysplastic changes.
