Clinical Data: 44-year-old patient with stomach pain and belching
Showing USG of the upper abdomen (stomach)
Showing Upper GI contrast study
Showing Abdomen CT:
Describe the findings in detail
Describe the findings in detail
US: Small capacity partially distensible stomach with appreciable wall thickening
Fluoroscopy:
·The stomach is not distended adequately
·A narrow lumen identified
·The normal mucosal fold pattern is distorted, thickened, and nodular
CT Scan:
·Small calcification in spleen
·No diverticulae
·No lymph nodes
·No ascites
Differential diagnosis includes:
Differential diagnosis
(1) Neoplastic
·Gastric adenocarcinoma (scirrhous)
·Metastases
(2) Lymphoma
(3) Diffuse gastric diverticula (rare)
(4) Inflammatory
·Radiotherapy
·Granulomatous disease
(5) Scarring (e.g., Ingestion of corrosives)
(6) Gastric amyloidosis
What is your provisional diagnosis?
Provisional diagnosis
Linitis plastica
Linitis plastica is the term attributed to the specific appearances of the stomach.
The stomach is small, non-distensible with a diffusely thickened wall, the appearance referred to as like a traditional water bottle.
The underlying cause is almost always a scirrhous adenocarcinoma with diffuse submucosal infiltration, which contributes to the thickening and rigidity to the stomach wall observed on CT or endoscopy.
Gastric lymphoma
References
- 1. Levine MS, Pantongrag-brown L, Aguilera NS et-al. Non-Hodgkin lymphoma of the stomach: a cause of linitis plastica. Radiology. 1996;201 (2): 375-8. Radiology (abstract)– Pubmed citation
- 2. Curati WL. Imaging in Oncology. Cambridge Univ Pr. (1998) ISBN:1900151030. Read it at Google Books– Find it at Amazon
- 3. Rudralingam V, Dobson MJ, Pitt M et-al. MR imaging of linitis plastica of the rectum. AJR Am J Roentgenol. 2003;181 (2): 428-30. AJR Am J Roentgenol (full text)– Pubmed citation
- 4. Burgener FA, Kormano M, Pudas T. Differential diagnosis in conventional radiology. Thieme Publishing Group. (2008) ISBN:3136561031. Read it at Google Books– Find it at Amazon
- 5. Chapman S, Nakielny R. Aids to radiological differential diagnosis. Saunders Ltd. (2003) ISBN:0702026506. Read it at Google Books– Find it at Amazon
- 6. Patel SD, Semeraro D, Hall RI. Linitis plastica due to gastric diverticulosis. J R Soc Med. 2005;98 (9): 416-7. doi:10.1258/jrsm.98.9.416– Free text at pubmed– Pubmed citation
