e19541 Background: Positron emission tomography (PET)/computed tomography (CT) scan has a well-established role in the management of non-Hodgkin's lymphoma (NHL). However, in case of the primary gastric lymphoma, which is the most frequent extranodal NHL, the role of PET/CT scan is still controversial. Methods: We retrospectively analyzed 42 patients with primary gastric lymphoma who underwent PET/CT scans; 32 patients with diffuse large B-cell lymphoma (DLBCL) and 10 patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) were analyzed. The PET/CT scans were compared with clinicopathologic features and the results of CT and endoscopy. After corresponding treatment, response was evaluated by conventional CT scans or PET/CT scans and endoscopy with biopsy Results: Nine patients were up-staged based on the results of their PET/CT scan compared to CT (7 DLBCL, 2 MALT lymphomas) while six patients were down-staged by the PET/CT scan. The high SUVmax group, defined as SUVmax ≥ median value, was significantly associated with an advanced Lugano stage (P < 0.001). Three patients with DLBCL, who showed an initially high SUVmax, died of disease progression. Although not statistically significant, there was a tendency of inferior outcome in the group with high SUVmax. Among 24 patients for whom follow-up PET/CT scan with endoscopy was performed, 11 patients with ulcerative or mucosal lesions showed residual FDG uptake. All of these gastric lesions were grossly and pathologically benign lesions without evidence of lymphoma cells. Conclusions: PET/CT scan can help staging patients with primary gastric lymphoma, and the maximum SUV has possibility to have prognostic value. However, the residual FDG uptake observed during follow-up should be interpreted cautiously in association with the results of endoscopy and multiple gastric biopsies. No significant financial relationships to disclose.