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[An autopsy case of gastric metastasis simulating linitis plastica carcinoma from primary linitis plastica carcinoma of the rectum].

Cases of a metastatic involvement of the stomach from a colorectal cancer are extremely rare, and once such case, confirmed by autopsy, is reported. The patient, an 86-year-old woman, had a metastatic lesion of the stomach from a rectal cancer. The rectal cancer was a combined linitis plastica type and signet ring cell carcinoma, and the appearance of metastatic lesion of the stomach had simulated the linitis plastica type cancer. A metastatic involvement of the stomach presenting a linitis plastica type cancer from a breast cancer is well documented, but a linitis plastica type from a colorectal cancer has not been reported. This case is the first report concerning a gastric metastasis presenting linitis plastica type lesion from a colorectal cancer.

Adenocarcinoma, Scirrhous

CT demonstration of pelvic wall spread in primary colonic linitis plastica.

Primary linitis plastica of the colon is a rare entity, and its radiographic and CT findings have been described in previously published literature. We present the CT demonstration of the pelvic wall spread in this unusual disease, and briefly review its radiologic and pathologic features.

Adenocarcinoma, Mucinous

Some specific radiological findings and consideration of linitis plastica of the gastrointestinal tract.

Linitis plastica denotes a diffuse, intramurally infiltrating, anaplastic carcinoma in a hollow structure resulting in a shrunken organ with thickened walls. Microscopically, linitis plastica is characterized by tumor cells in the presence of inflammatory changes with much fibrosis. Linitis plastica is found most frequently in the stomach where it may produce the classical "leather-bottle stomach". Metastases to the colon are frequent via contiguity along mesenteric fascial planes. Therefore, when linitis plastica carcinoma of the stomach or colon is found, the other organ must also be carefully examined. Although rare, primary linitis plastica carcinoma can occur in the colon where it is often characterized by a long stenotic lesion without irritability, sometimes appearing more like an inflammatory lesion than a carcinoma. While the radiological features are not diagnostic, they are, in many cases, suggestive of this entity. The entire spectrum of linitis plastica is reviewed in relationship to the gastrointestinal tract, synthesizing the pertinent literature, with correlation of clinical, pathophysiological, and specific radiological findings.

Adenocarcinoma, Scirrhous

Linitis plastica carcinoma of the colon mimicking Crohn's colitis.

Primary linitis plastica carcinoma of the colon is an uncommon morphological type of colorectal carcinoma. Linitis plastica of the stomach may spread to the colon producing a similar lesion to primary colonic linitis plastica. This case report describes a case of linitis plastica of the colon that had many of the clinical, endoscopic, radiological and operative features of Crohn's colitis. The precise origin of the linitis plastica carcinoma was not clear: it may have been clonic or gastric, although the former is favoured. This case illustrates a number of facets of this unusual colonic carcinoma.

Biopsy

Primary linitis plastica carcinoma of the colon and rectum.

Linitis plastica carcinoma of the colon and rectum is a relatively rare primary colorectal malignancy. The initial diagnosis of this disease is often difficult, and its eventual prognosis is poor. In this report, we describe a case of primary linitis plastica of the rectum in a 57-yr-old American Indian. This case is unique since it represents the first documentation of a primary rectal lesion with metastases to the stomach. The current literature is reviewed with examination of the clinicopathologic features of this neoplasm.

Adenocarcinoma, Scirrhous

Primary linitis plastica of the small bowel. Case report.

Linitis plastica carcinoma of the gastrointestinal tract is rare. No case with origin in the small intestine has been reported in the available literature. A 29-year-old man with vague abdominal symptoms and bilateral inguinal lymphadenopathy was found to have primary linitis plastica of the ileum. The prognosis is poor.

Adult

An African patient with AIDS and linitis plastica.

This is a case report about an African patient with AIDS who was diagnosed with a linitis plastica of the stomach. The evolution of this linitis plastica does not differ in any aspect from that in HIV-negative patients. The question remains unanswered whether there is a link between the HIV infection and the development of linitis plastica in this patient.

Acquired Immunodeficiency Syndrome

Metastatic carcinoma simulating linitis plastica of the colon. A case report.

Reported herein is the case of a 70-year old woman with metastatic breast carcinoma presenting as linitis plastica of the ascending colon. The breast tumor was diagnosed nine years previously. The clinical, roentgenographic and pathologic features of colonic linitis plastica and the preoperative diagnostic difficulties are discussed. There is no difference in the morphologic features of primary and secondary linitis plastica. The latter may result from anaplastic carcinoma of the stomach, gallbladder or breast.

Adenocarcinoma, Scirrhous

[Primary colonic linitis plastica. Apropos of 3 new cases].

Primary linitis plastica of the colon is unfrequent. Since Laufmann and Saphir's first cases in 1951, less than 50 cases have been described, to which our three new cases now add. The intramural origin with late involvement of the mucosa delays the onset of clinical signs, and accounts for the rarity of overt bleeding and for the frequent failure of biopsy. The radiological appearance is that a tubular colic narrowing without ulceration or intraluminal process. Endoscopy shows regular, centered stenosis with few modifications of the mucosa. The clinicopathological diagnosis is primarily microscopic: presence of isolate mucosecretory neoplastic cells infiltrating the whole wall of the colon without destroying it. Because of its potential for local invasion and of its centripetal extension, linits is often detected only at the equivalent of stage C (Astler-Coller). The prognosis is poor, with survival averaging 1 year after the onset of the first clinical signs.

Adult

Primary linitis plastica of the descending colon: a case report.

A rare case of primary linitis plastica carcinoma of the colon seen in a 44 year old Japanese man is described herein. The patient had a complete obstruction of the descending colon and was treated with a loop colostomy followed shortly afterward by a left hemicolectomy. At the time of the second operation, the entire thickness of the colonic wall was found to be infiltrated by cancer cells, however, the other intraabdominal organs were free of cancerous involvement. The histopathological diagnosis made at this time was primary linitis plastica carcinoma of the descending colon. Nine months later, the patient developed an intestinal obstruction and relaparotomy revealed diffuse peritoneal dissemination. Two years after the first operation, upper GI films and a gastrofiberscopic examination revealed gastric involvement. The patient died 28 months after his initial operation, and autopsy revealed widespread metastases in the peritoneal surface, paraaortic lymph nodes, small intestine, remaining colon and stomach.

Adenocarcinoma, Scirrhous

Clinicopathological and histochemical studies of linitis plastica type gastric cancer with special reference to early gastric cancer in the region of the fundic gland.

In this study, early gastric cancer in the region of the fundic gland was found to occur predominantly in women. Many lesions of this type were identified in the posterior wall of the middle portion of the stomach. Histologically, the lesions were classified as poorly differentiated carcinomas in all cases of early cancer. On the other hand, in 9 patients with cancer of linitis plastica type having IIc lesions (less than 2.0 cm in diameter) located in the region of the fundic gland, the tumor focus was also in the posterior wall of the middle portion of the stomach. Giant folds were present diffusely in all other portions of the gastric mucosa in these latter cases. These cases also had diffuse infiltration of cancer cells into the submucosa, muscle layer and extraserosal regions. Histologically, the lesions were classified, in all cases of linitis plastica type, as poorly differentiated carcinomas including signet ring cells. Acid mucopolysaccharides (AMPS) and sialic acid were histochemically detected in the interstitial tissues of early gastric carcinomas and linitis plastica type gastric cancers. The AMPS digestion rates were higher for early cancer tissue. The present results support the hypothesis that early gastric cancer in the region of the fundic gland may occur in conditions favorable to tumor growth and may develop into cancer of linitis plastica type.

Adult

[Clinicopathological and histochemical studies of linitis plastica type gastric cancer with special reference to early gastric cancer in the region of the fundic gland].

Early gastric cancer in the region of the fundic gland was found to occur predominantly in women. Many lesions of this type were identified in the posterior wall of the middle portion of the stomach. Histologically, the lesions were classified as poorly differentiated carcinomas in all cases of early cancer. In 9 patients with cancer of linitis plastica type having IIc lesions located in the region of the fundic gland, the tumor focus was also in posterior wall of the middle portion of the stomach. Giant folds were present diffusely in all other portions of the gastric mucosa in these latter cases. These cases also had diffuse infiltration of cancer cells into the submucosa, muscle layer and extraserosal regions. Histologically, the lesions were classified in all cases of linitis plastica type as poorly differentiated carcinomas including signet ring cells. Acid mucopolysaccharides (AMPS) and sialic acid were histochemically detected in the interstitial tissues of early gastric carcinomas and linitis plastica type gastric cancers. The AMPS digestion rates were higher for early cancer tissue. The present results support the hypothesis that early gastric cancer in the region of the fundic gland may occur in conditions favoring tumor growth and may develop into cancer of linitis plastica type.

Adenocarcinoma, Mucinous

Kaposi's sarcoma presenting as linitis plastica.

A 31-yr-old woman presenting with abdominal complaints and fever was found to have linitis plastica on upper gastrointestinal series. Endoscopic studies confirmed these findings; however, pathology revealed the diagnosis to be Kaposi's sarcoma. We believe this to be the first case report of linitis plastica presenting as Kaposi's sarcoma.

Adult

Gastric linitis plastica with metastases to the colon: a mimic of Crohn's disease.

A 60-year-old woman had progressive lower abdominal pain, nonbloody diarrhea, and weight loss, followed by severe epigastric pain and dysphagia. Radiographic evaluation of the colon showed segmental strictures which were interpreted as Crohn's disease. Medical treatment was not helpful. Neither gross endoscopic appearance nor multiple biopsies of the esophagus, stomach, and colon were diagnostic. Finally, laparotomy with full-thickness biopsies of the stomach and colon revealed linitis plastica. The clinician should be alert to colonic metastases from gastric linitis plastica, for it can produce focal or segmental strictures, mimicking more common colonic diseases such as Crohn's disease. A full-thickness biopsy is often necessary for a firm diagnosis. We review the literature on this occurrence, highlighting the clinical and radiologic spectrum, as well as the organ systems most often affected when gastric linitis plastica metastasizes.

Adenocarcinoma, Scirrhous

Linitis plastica of the colon: computed tomography findings.

Primary linitis plastica of the colon is a rare entity and its radiographic findings have been described previously in the literature. We present the computed tomography findings of this unusual lesion and briefly review its pathogenesis.

Adenocarcinoma, Scirrhous

Obstructive uropathy. An unusual presentation of primary linitis plastica of the colon.

A patient with primary linitis plastica of the colon has been presented. The unusually aggressive nature of this tumor is demonstrated in a young man who presented with obstructive uropathy. Extensive renal involvement is a rare complication of this disease, and obstructive uropathy is a previously undescribed presentation. If early recognition is to favorably alter prognosis, then awareness of this form of colonic malignancy is essential.

Adenocarcinoma, Scirrhous

Corrosive gastritis mimicking linitis plastica carcinoma.

A 59-year-old female with depressive tendencies was admitted suffering from hematemesis and abdominal pain, two hours after ingestion of an unknown amount of toilet bowl cleaner (hydrochloric acid, pH 1.0). A barium study 24 days after ingestion revealed rigid narrowing and granulation of the entire stomach. The esophagus and duodenum were normal. The radiographic results were similar to those obtained for linitis plastica carcinoma of the stomach, but biopsy specimens of the stomach revealed no cancer cells. A total gastrectomy was performed about two months after ingestion to relieve the persistent feeling of nausea. Specimens revealed a rigid and thickening lining and a denuded mucosal surface of the stomach. The cut surface of the specimen showed a remarkable fibrous thickening of the submucosal layer. Microscopic examination failed to reveal a normal mucosal layer except in a narrow area of the fornix, and remarkable fibrosis of the submucosal lining was noted. No cancer cells were found. Corrosive gastritis has a linitis plastica appearance with a predilection for the antrum. Radiological examination revealed the very rare manifestation of a rigid narrowing of the whole stomach mimicking linitis plastica type cancer.

Adenocarcinoma, Scirrhous

Linitis plastica in a child.

Anaplastic infiltrative adenocarcinoma of the linitis plastica morphologic type is rare in children. The case of a 15-year-old child with this unusual form of gastric carcinoma is presented. One year postoperatively following radiation and chemotherapy, the child is free of disease.

Adenocarcinoma, Scirrhous