Linitis plastica due to gastric adenocarcinoma is a condition with a long history, but still lacks a standardized definition and is commonly confused with borrmann type iv, lauren diffuse, and signetcell type. Linitis plastica refers to the diffuse proliferation of the connective tissue, resulting in tissue thickening so that the stomach is constricted and rigid. Linitis plastica refers to a circumferentially infiltrating intramural anaplastic carcinoma in a hollow viscus, usually the stomach, though rarely the colon or rectum. She underwent laparoscopic partial gastrectomy to confirm a diagnosis. Linitis definition of linitis by the free dictionary. Thus the cause of linitis plastica are also the differential, and include 4,5. Linitis plastica definition of linitis plastica by the. A type of adenocarcinoma that diffusely infiltrates the stomach wall, linitis plastica figure 4, accounts for the remaining 10%. In most cases, the primary cancer cells are signetring cells or scattered cells in the context of a poorly differentiated carcinoma. For more treatment information about linitis plastica, see treatment of gastric cancer, borrmann 4 linitis plastica hierarchical classifications of linitis plastica the following list attempts to classify linitis plastica into categories where each line is subset of the next.
Linitis plastica, a type of adenocarcinoma that diffusely infiltrates the stomach wall, accounts for the remaining 10% of cases. Jul 05, 2017 linitis plastica lp of the stomach is a longknown condition, with initial reports that date back to the sixteenth and seventeenth century. Survival following operative management of gastric linitis. Jan 27, 2011 by definition of linitis plastica on the postoperative histopathological specimen all included patients presented with a locally advanced tumor stage pt3 or pt4 category, and diffuse infiltration of neoplastic signet ring cells. Linitis plastica, a scirrhous carcinoma most commonly of gastric origin, is characterized by diffuse infiltration resulting in thickening and stiffening of the gastric wall. Gastric carcinoma can manifest as large, polypoid, fungating lesions,, fig 4a. Gastric cancer pathophysiology gastrointestinal cancer. In some texts, the term is also used to describe the condition of a rigid, nondistensible stomach which may be caused by a nonmalignant condition such as a caustic injury to the stomach. Endoscopic image of linitis plastica, where the entire stomach is invaded with stomach cancer. Metastatic pancreatic cancer presenting as linitis plastica of the stomach. We present an interesting case of a woman with a known history of breast cancer in remission who was evaluated for dyspeptic symptoms and weight loss fig. Metastatic disease from pancreatic carcinoma involving the stomach is an unusual event, and the pattern of spread in the form of linitis plastica, to our knowledge, has not been reported previously.
A rare case of gastric linitis plastica revealed by isolated. A 66yearold female was admitted to kagawa university hospital kagawa, japan with epigastric pain. Linitis plastica definition of linitis plastica by the free. In summary, this patient was originally diagnosed with a transmural poorly differentiated adenocarcinoma of the stomach, described as linitis plastica, with spread to a lymph node and with both surgical margins positive. Gastric linitis plastica video journal and encyclopedia of. Linitis plastica medical definition merriamwebster medical. The results of eus fna for the diagnosis of linitis plastica are poor sensitivity. Lp is a diffusetype carcinoma with a scirrhous stroma, involving the submucosal and muscular layers of the stomach. An unusual cause of gastric linitis plastica gastroenterology. Despite improved treatment outcome for other types of gastric carcinoma in japan, the prognosis in linitis plastica remains extremely poor 1. A condition where the stomach wall becomes thickened, rubbery and loses its ability to distend. Linitis plastica is a carcinoma with a scirrhous stroma, involving the submucosal and muscular layers of the stomach even in the absence of mucosal alteration.
The purpose of our retrospective study was to characterize the clinicopathologic features and survival outcomes of patients with lp, using a univocal definition. This rare malignant cancerous disorder is a form of adenocarcinoma and accounts for approximately 3 to 19. Gastric linitis plastica is a specific form of gastric cancer. Sasaki t, koizumi w, tanabe s, higuchi k, nakayama n, saigenji k anticancer drugs 2006 jun. Linitis plastica medical definition merriamwebster. Pdf on mar 1, 2019, yusaku kajihara published linitis plastica. Pdf linitis plastica lp is a particular subtype of diffuse gastric cancer. Linitis plastica was defined based on histological characteristics.
A high index of suspicion must be present when this appearance is identified, as mucosal biopsies are often negative and deeper biopsies are required to make. The appearance is said to be reminiscent of an old leather waterbottle. Meticulous preoperative staging, including a diagnostic laparoscopy to exc prognostic factors in patients with diffuse type gastric cancer linitis plastica after operative treatment. Results of surgery were analyzed in 102 patients with glp. Metastasis to the gi tract may manifest as intestinal wall thickening or linitis plastica if spread to the stomach 2, 6. The significance of a nineteenth century definition in the era of. Gastric linitis plastica is a diffuse type of cancer which is characterised by a. Under a microscope, these appear as signet ring cells, meaning that mucin droplets are. Less frequently, metastatic gastric cancer from the breast, omental metastases. By definition of linitis plastica on the postoperative histopathological specimen all included patients presented with a locally advanced tumor stage pt 3 or pt 4 category, and diffuse infiltration of neoplastic signet ring cells. Linitis plastica definition of linitis plastica by medical.
Gastric linitis plastica accounts for 10%15% of gastric cancers and presents particular characteristics compared to classic adenocarcinoma. William brinton, who described it as a benign disease with peculiar characteristics. Linitis plastica can occur in any organ but is more prev alent in hollow viscous organs, especially in the stomach 1,2. Characteristic wafflelike appearance of gastric linitis plastica. Linitis plastica, also known as brintons disease or leather bottle stomach, is a morphological variant of diffuse stomach cancer. Neither histological examination of biopsy specimens of the gastric body nor cytological analysis of the pleural effusion and ascites showed signs of malignancy. The diffusely infiltrative carcinomas showed diffusely thickened gastric wall with three cases of linitis plastica type of tumours. Linitis plastica lp denotes a diffuse, intramurally infiltrating, primary or secondary anaplastic adenocarcinoma in a hollow structure, resulting in a shrunken organ with thickened walls. Gastric linitis plastica is a very particular malignant gastric tumor different from the usual gastric.
Linitis plastica, or leather bottle stomach, is a spread in this area of fibrous tissue as a response to cancer of the stomach. Dr michael p hartung and assoc prof frank gaillard et al. Linitis plastica of the rectum is usually the result of primary disease in the stomach, prostate gland, or breast. Jan 27, 2016 to analyze the features of gastrointestinal linitis plastica obtained by computed tomography ct. Information and translations of linitis plastica in the most comprehensive dictionary definitions resource on the web. Characteristic wafflelike appearance of gastric linitis. Linitis plastica is a term designating clinically a skiagraphic and, in the. Structure and function of helicobacter pylori caga, the firstidentified bacterial protein involved in human cancer.
Linitis plastica definition of linitis plastica by. Causes of linitis plastica could be lye ingestion or metastatic infiltration of the stomach, particularly breast and lung carcinoma. Metastatic gastric linitis plastica from bladder cancer. Mar 03, 2017 linitis plastica lp is a particular subtype of diffuse gastric cancer and is thought to have a very poor prognosis. Linitis plastica is a widely used term for brintons disease a morphological variant of diffuse or. Linitis plastica lp is a particular subtype of diffuse gastric cancer and is thought to have a separate entity in respect with its biological behaviour, pathology, presentation and treatment. Linitis plastica is a gastric cancer of diffuse histotype that is characterized by thickening of the stomach wall and deformation of the stomach, resulting in a leather bottlelike appearance. Ts1 as firstline therapy for gastric linitis plastica. Linitis plastica represents a diffuse process within the gastric body of enlarged, often edematous and erythematous, folds with poor distensibility of the gastric wall with insufflation. The absence of a clear definition is a problem when investigating its biological characteristics and role as a possible independent factor for prognosis. Linitis definition of linitis by medical dictionary. Hereditary syndromes, pernicious anemia, and prior partial gastrectomy are among the endogenous risk factors. Macroscopically, lp is conventionally described as diffuse infiltration, frequently circumferential, involving more than of the stomach surface and most of the time the entire surface, causing thickening and.
It is frequently diagnosed in younger patients, at a more advanced stage, and with poorer. It represents about 319% of primitive gastric adenocarcinomas, but it can also be the manifestation of a metastatic disease. Linitis plastica is defined as a gastric cancer of diffuse histotype 1 that. To the best of our knowledge, this is the first report of an infiltrating urothelial carcinoma of bladder presenting as linitis plastica of the stomach. Linitis plastica lp is a distinct phenotype of gastric carcinoma, which includes both macroscopic and microscopic features. Linitis plastica is not considered a separate entity in the staging or classification of gastric cancer. Linitis plastica due to gastric adenocarcinoma is a condition with a long history, but still lacks a standardized definition and is commonly confused with borrmann type iv, lauren diffuse, and signetcell type gastric cancer. The neoplasm is encountered in every segment of gastrointestinal tract, with the gastric localization being the most frequent. It rarely involves the colon but, when it does, is usually a manifestation of. Alternative treatments for linitis plastica of the stomach. We believe that case 1 was due to primary linitis plastica of the rectum, because no evidence of disease was seen. It is most often seen in adenocarcinoma of the stomach.
The stomach and duodenum are closely related in function and in pathogenesis and manifestation of disease. Ks may also present in the stomach as linitis plastica. These findings suggested linitis plastica of the stomach. Dec 22, 2020 linitis plastica is not considered a separate entity in the staging or classification of gastric cancer. This subtype of diffuse gastric cancer is called scirrhous gastric cancer or linitis plastica, 5 the prognosis of which is extremely poor. Detection of disseminated cancer cells in linitis plastica. Primary colorectal linitis plastica is rare, with a reported incidence of less than 0. We defined lp as gastric cancer that involves more than of the gastric wall macroscopically. A rare case of gastric linitis plastica revealed by. Gastric linitis plastica is a very particular malignant gastric tumor different from the usual gastric adenocarcinoma. A case report of gastric linitis plastica diagnosed by endos. Linitis plastica also known as brintons disease, leather bottle stomach, or gastric scirrhous carcinoma is a morphological variant of infiltrating stomach cancer. The modifiable risk factors include helicobacter pylori infection, smoking, and nitraterich diets. Gastric cancer is the 3rdmost common cause of cancerrelated deaths worldwide.
Linitis plastica of the rectum keogh 2002 journal of. Linitis plastica is a carcinoma with a scirrhous stroma, involving the submucosal and muscular layers of the stomach even in the absence of. Fna with a 22g needle was initially attempted, but. Approximately 95% of stomach tumors are epithelial in origin and are classified as adenocarcinomas. Metastatic pancreatic cancer presenting as linitis.
An endoscopic aspect of large gastric folds that fail to distend on. The significance of a nineteenth century definition in the. Inflammation of the layer of the stomach wall below the mucous membrane lining. Pathology showed transmurally infiltrating poorly differentiated adenocarcinoma of the stomach, predominantly linitis plastica type, with extensive intraneural infiltration and spread, with microscopic involvement of both proximal and distal margins of resection, and with metastases. On palpation, the abdomen of the patient was soft and flat, with no. The operative approach in patients with lp has historically been questioned because of the poor outcomes. Of the 102 patients, 92 underwent surgical exploration, with resection performed in 60 cases.
Gastric linitis plastica and peritoneal carcinomatosis as. A clinicopathological study of tumours and tumourlike lesions of the stomach. A, endoscopic image of an ulcerating adenocarcinoma. A, ct image of linitis plastica arrows denote a thickened gastric wall. Nov 21, 2019 the prognosis of patients with linitis plastica lp gastric cancer is reported to be poor. Linitis plastica lp is a particular subtype of diffuse gastric cancer and is thought to have a separate enti ty in respect with its biological behaviour, pathology, presentation and treatment. Whether you define linitis plastica as only the appearance of the stomach, irrespective of cause or use it only in the setting of infiltrating adenocarcinoma of the stomach is up to you, but be aware that there does not appear to be general agreement. Computed tomography features of gastrointestinal linitis. Linitis plastica is a gastric cancer of diffuse histotype that presents in the fundic gland area, and is characterized by thickening of the stomach wall and deformation of the stomach, resulting in a leather bottlelike appearance.
Egd showed diffuse thickening of the entire stomach mucosa, and eus showed a thickened gastric wall figure 2, figure 3, figure 4. A condition where the stomach wall becomes thickened, rubbery and loses its ability to distendthe stomach assumes a leather bottle shape. We could define a subset of patients with an extremely poor prognosis even after surgical resection. Local recurrence after curative resection for pancreatic cancer is the most common pattern of disease. Gastric linitis plastica gastric lp is a malignant, diffuse, infiltrative gastric adenocarcinoma. Linitis plastica lp denotes a diffuse, intramurally infiltrating, primary or. The aim of this study was to determine the current outcomes in lp patients who undergo radical resection.
Jun 30, 2011 the role of surgery for gastric linitis plastica glp is questioned. This study aimed to analyze our experience in the surgical treatment of glp with specific reference to the resectability rate, prognosis, and mode of recurrence. All tumors belonged to the diffuse type according to the lauren classification. We conducted a singlecenter, retrospective analysis of 45 cases of gastrointestinal tract linitis plastica collected over a 10year period. Gastric linitis plastica video journal and encyclopedia. Linitis plastica definition of linitis plastica at. Signetring cell cancer usually manifests as a scirrhous tumor of the stomach that leads to obliteration of gastric folds and diffuse thickening of the gastric wall linitis plastica,, fig 3c. Linitis plastica refers to thickening, decreased motility, and increased rigidity of the wall of a hollow organ, classically the stomach. Although gastric linitis also occurs at young people, any described case under 36 wasnt found as our case. Primary and secondary linitis plastica were included. Prognostic factors in patients with diffuse type gastric.
Endoscopic ultrasound efficacy in staging gastric linitis. Gastric linitis plastica is a diffuse involvement of the stomach walls by neoplastic cells. Linitis plastica is a descriptive term usually referring to the appearance of the stomach, although the rectum can also be described this way. Stage iv gastric cancer, sometimes referred to as advanced gastric linitis plastica lp, is defined as the characteristic thickening and hardening of the gastric wall without marked ulceration or elevation and is distinguished by an undistinguishable unclear boundary between the focal lesion and the surrounding mucosa. The tumor cells or their products cause a marked desmoplastic response resulting in a rigid shrunken viscus with thickened walls 2. This rare malignant cancerous disorder is a form of adenocarcinoma and accounts for approximately 3 to 19 percent of all gastric adenocarcinoma cases. Jun 01, 20 linitis plastica lp denotes a diffuse, intramurally infiltrating, primary or secondary anaplastic adenocarcinoma in a hollow structure, resulting in a shrunken organ with thickened walls.
284 1596 852 1551 404 429 306 182 1396 1555 973 1662 1667 858 1441 426 442 1540 696 816 327 1729 80 507 1325 1560