Presentation
Methods: We present the case of a 57-year-old woman with a history of signet cell gastric adenocarcinoma (linitis plastica) and a Krukenberg tumor who presented with nausea, blurry vision, and a chronic headache of two months’ duration. [n.neurology.org]
As many of the presenting symptoms can be non-specific, there may be a delay in diagnosis. LP can, however, be diagnosed in a multitude of ways. [cancertherapyadvisor.com]
We present a case of signet ring gastric adenocarcinoma masquerading as retroperitoneal fibrosis. A 50-year-old diabetic female patient presented with a history of right flank and lower abdominal pain for the past 2 months. [indianjrheumatol.com]
Case Report A 34-year-old woman presented with new-onset ascites and worsening jaundice. [acgcasereports.gi.org]
Entire Body System
- Weight Loss
Left: 76 year-old woman with several months of progressive loss of appetite, early satiety and weight loss. The walls of the stomach appeared thickened, and the stomach distended poorly. [endoatlas.com]
Dyspepsia was the commonest feature of presentation (55%), followed by dysphagia (33%), vomiting (33%) and weight loss (33%). [ncbi.nlm.nih.gov]
The second patient, a 58-year-old woman, was referred for rou- tine gastroscopy with complaints of dysphagia, lack of appetite, fast food saturation, and weight loss. [slideshare.net]
- Weakness
An 80-year-old woman with no preceding history of autoimmune disease, malignancy or jaundice was admitted for a periorbital heliotrope rash [Figure 1] with muscle weakness. [ijdvl.com]
[…] to have a more caudal extension, whereas the idiopathic RPF tends to be predominantly below the renal hilum[6] Based on diffusion-weighted imaging: active RPF and malignant lesions have similarity in the enhancement pattern, while chronic RPF shows weak [indianjrheumatol.com]
Review of systems revealed “swollen” neck lymph nodes, but no fever, night sweats, weight loss, bruising, jaundice, or weakness. There were 1.5-cm bilateral cervical and axillary lymph nodes but no hepatosplenomegaly. [thepermanentejournal.org]
- Pallor
[…] gmail.com DOI : http://dx.doi.org/10.7869/tg.274 Case report A 43-year-old lady without associated comorbidity presented with upper abdominal dull aching pain, persistent nonbilious vomiting,loss of appetite and loss of weight.Clinical examination revealed pallor [tropicalgastro.com]
Physical examination upon admission revealed no anemia (via conjunctival pallor examination), jaundice or pulmonary abnormalities. On palpation, the abdomen of the patient was soft and flat, with no areas of tenderness. [ncbi.nlm.nih.gov]
食道損傷 esophageal perforation食道穿孔 esophageal varices食道静脈瘤 esophagitis食道炎 esophagography食道造影 excretory duct導管 exocrine gland外分泌腺 external biliary fistula外胆汁瘻 extracorporeal shock wave lithotripsy (ESWL)体外衝撃波結石破砕術(ESWL) extrahepatic bile duct肝外胆管 f facial pallor [tokyo-med.ac.jp]
Respiratoric
- Aspiration
(Peritoneal Recurrence Index NomoGRAM) for predicting the risk of metachronous peritoneal carcinomatosis after gastrectomy with curative intent for gastric cancer. 62 Agnes A...D'Ugo D 34811622 2022 18 Use of endoscopic ultrasound-guided fine needle aspiration [malacards.org]
The safety of fine-needle aspiration guided by endoscopic ultrasound: a prospective study. Endoscopy 2008;40:204–8. [16]. Kobara H, Mori H, Rafiq K, et al. [journals.lww.com]
Subsequent endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of the stomach yielded abundant single, discohesive malignant cells suspicious for lymphoma vs. poorly differentiated carcinoma. [ncbi.nlm.nih.gov]
Gastrointestinal
- Vomiting
A 52-year-old Caucasian woman presented with progressive nausea and vomiting, weight loss, and burning epigastric and chest pain. [ncbi.nlm.nih.gov]
There are no characteristic or specific symptoms, the symptoms are similar to those of other forms of stomach cancer and can manifest as a feeling of fullness after eating, nausea and vomiting, epigastric pain, weight loss, and progressive dysphagia [ [slideshare.net]
Sijil kottikkal sivaraman Email: [email protected] DOI : http://dx.doi.org/10.7869/tg.274 Case report A 43-year-old lady without associated comorbidity presented with upper abdominal dull aching pain, persistent nonbilious vomiting,loss of appetite and [tropicalgastro.com]
- Dysphagia
The first patient, a 66-year-old woman, was referred for routine gastroscopy with complaints of dysphagia and difficulty clinicsofoncology.com 3 2. passing solid food. [slideshare.net]
A 60-year-old woman had progressive lower abdominal pain, nonbloody diarrhea, and weight loss, followed by severe epigastric pain and dysphagia. [ncbi.nlm.nih.gov]
There are no characteristic or specific symptoms, the symptoms are similar to those of other forms of stomach cancer and can manifest as a feeling of fullness after eating, nausea and vomiting, epigastric pain, weight loss, and progressive dysphagia [ [clinicsofoncology.com]
- Abdominal Pain
We report a case of primary linitis plastica of the sigmoid colon in a 32-year-old Chinese woman who presented with a 7-month history of constipation and associated abdominal pain and tenesmus. [ncbi.nlm.nih.gov]
- Nausea
Methods: We present the case of a 57-year-old woman with a history of signet cell gastric adenocarcinoma (linitis plastica) and a Krukenberg tumor who presented with nausea, blurry vision, and a chronic headache of two months’ duration. [n.neurology.org]
A 52-year-old Caucasian woman presented with progressive nausea and vomiting, weight loss, and burning epigastric and chest pain. [ncbi.nlm.nih.gov]
There are no characteristic or specific symptoms, the symptoms are similar to those of other forms of stomach cancer and can manifest as a feeling of fullness after eating, nausea and vomiting, epigastric pain, weight loss, and progressive dysphagia [ [slideshare.net]
- Early Satiety
Early satiety may be more prominent in patients in LP based on the diffuse involvement of the stomach, which causes limited distensibility. [cancertherapyadvisor.com]
Left: 76 year-old woman with several months of progressive loss of appetite, early satiety and weight loss. The walls of the stomach appeared thickened, and the stomach distended poorly. [endoatlas.com]
In retrospect, the patient was questioned regarding gastrointestinal symptoms; he reported gradual early satiety, dysphagia and unintentional weight loss over the course of 4 months. [casereports.bmj.com]
The player requires Flash Player plugin Case description A 35 year-old female, who began her disease with jaundice, weight loss, early satiety, nausea and vomiting. The endoscopy was performed and all the gastric mucosa and walls were infiltrated. [medtube.net]
Patients with LP will have more intense symptoms presented with gastric cancer in addition to early satiety and how much stomach involvement there is since it may lead to limited distensibility. Diagnosis & Staging View Full Article Related Videos [debbiesdream.org]
Cardiovascular
- Hypertension
This kind of gross GB morphology simulated cholecystitis resulting from chronic, acute-on-chronic, or xanthogranulomatous etiology; adenomyomatosis; portal hypertension; congestive cardiac failure, etc. [ccij-online.org]
The mucosa shows a mosaic pattern that resembles the pattern that we know from portal hypertensive gastropathy. 00:40 The gastric wall is rigid and hardly distends upon constant air insufflation. There is no peristalsis at all. [videogie.org]
Her family health history was negative, whereas her medical history included medications for hypertension and diabetes mellitus over the last 10 years. [e-ce.org]
Her medical history was significant for hypertension and irritable bowel syndrome. On physical examination, her abdomen was distended with generalized tenderness, but no guarding was noted. [journals.lww.com]
The patient had a history of hypertension and obstructive sleep apnea syndrome. Physical examination upon admission revealed no anemia (via conjunctival pallor examination), jaundice or pulmonary abnormalities. [ncbi.nlm.nih.gov]
- Heart Failure
Furthermore, other conditions such as fluid overload, heart failure, or postoperative state may contribute to rectal wall thickening. [ajronline.org]
Skin
- Erythema
Physical examination revealed discrete erythematous papules overlying the interphalangeal joints (Gottron's papules) [Figure 2] and prominent periungual erythema with ragged cuticles (manicure sign) [Figure 3]. [ijdvl.com]
The gold standard investigation to diagnose gastric Crohn’s is endoscopic biopsy. [2 ] The usual endoscopic findings are focal gastritis appearing as erythema, mucosal friability, thickened folds, and ulcerations. [tropicalgastro.com]
- Papule
Figure 2: Gottron's papules on the left foot. [ijdvl.com]
Musculoskeletal
- Muscle Weakness
Manual muscle testing showed proximal muscle weakness (2/5 according to Medical Research Council Scale). Elevated serum muscle enzymes were observed with increased creatine kinase to 426 U/L (normal [Figure 4], [Figure 5], [Figure 6]. [ijdvl.com]
- Low Back Pain
[…] attenuation: 낮은 감약 low back pain: 요통 low echo area: 저에코구역 low field MR scanner: 저자장자기공명스캐너 low intensity void in proton flow: 양성자흐름의 저강도소실 low pass filter: 저통과여과기 low signal: 저신호 low signal intensity: 저신호강도 lower abdominal pain: 하복부통 lower cranial nerve [pann.nate.com]
- Bone Pain
ALP trended down to 983 U/L after systemic chemotherapy Conclusions Our case highlights the importance of a broad differential diagnosis when approaching a patient with bone pain. [afmr.org]
Psychiatrical
- Suggestibility
In this case, there was no history suggestive of a gastric malignancy. On the contrary, the presence of bilateral hydroureteronephrosis with febrile UTI was suggestive of an idiopathic RPF. [indianjrheumatol.com]
This suggests a higher incidence of CNS metastases from a gastric primary than the 0.06[percnt] previously reported in other studies. [n.neurology.org]
This appearance is highly suggestive of adenocarcinoma of the stomach & biopsy is suggested. [radiopaedia.org]
Detection of disseminated cancer cells in linitis plasticatype gastric Download PDF Download. are suggestive for gastric linitis. this is the typical appearance of linitis plastica of the gastric corpus. [paytranalcos.gq]
Workup
Post -operative clinico-radiological workup was done to exclude secondary. [ncbi.nlm.nih.gov]
The mucosa can, however, also appear normal, which requires high clinical suspicion in further workup. The antrum and pylorus are most commonly involved in LP, while the fundus is the least involved. [cancertherapyadvisor.com]
In addition, this video provides the viewer a comprehensive workup of such a patient presentation with radiologic and endoscopic diagnostic modalities utilized. [endoscopedia.com]
The patient was admitted to the hospital and underwent an additional workup, including upper endoscopy. The endoscopic examination revealed a large friable mass in the antrum. [onlinelibrary.wiley.com]
The patient was diagnosed as Crohn’s disease and further workup revealed multiple strictures in the small bowel though large bowel was normal and subsequently managed with azathioprine and supportive medications. [tropicalgastro.com]
Biopsy
- Hepatocellular Carcinoma
Linitis plastica pancreas (Insulinoma, Glucagonoma, Gastrinoma, VIPoma, Somatostatinoma) Cholangiocarcinoma - Hepatocellular adenoma/Hepatocellular carcinoma - Adenoid cystic carcinoma - Familial adenomatous polyposis - Prolactinoma - Oncocytoma - Hurthle [bionity.com]
Chronic hepatitis C virus infection associated with dermatomyositis and hepatocellular carcinoma. Chang Gung Med J 2004;27:834-9. [ PUBMED ] 3. McMurray RW, Elbourne K. Hepatitis C virus infection and autoimmunity. [ijdvl.com]
Frequent loss of heterozygosity for loci on chromosome 8p in hepatocellular carcinoma, colorectal cancer, and lung cancer. [qjmed.oxfordjournals.org]
肝性脳症 hepatic failure肝不全 hepatic fibrosis肝線維化 hepatic hemangioma肝血管腫 hepatic lobe肝葉 hepatic regeneration肝再生 hepatic segmentation肝区域 hepatic transcatheter arterial embolization (TAE)肝動脈塞栓療法 hepatic trauma肝外傷 hepatitis肝炎 hepatitis AA型肝炎 hepatoblastoma肝芽腫 hepatocellular [tokyo-med.ac.jp]
Treatment
[…] of idiopathic RPF, treatment of the secondary forms of RPF requires an approach based on the cause. [indianjrheumatol.com]
Sometimes an endoscopic ultrasound is useful to establish the diagnosis and in guiding treatment. The treatment for linitis plastica is a controversial issue. [ncbi.nlm.nih.gov]
Prognosis
Of significance is the fact that it carries a prognosis that is poor compared to other types of colorectal cancers. [ncbi.nlm.nih.gov]
June 07, 2017 The diagnosis of linitis plastica, a subtype of gastric adenocarcinoma with a poor prognosis, can be difficult and uses a multifaceted approach between endoscopic and radiologic studies. [cancertherapyadvisor.com]
The low index of suspicion for this tumour in children results in advanced disease at diagnosis and subsequently a poor prognosis. [jpgmonline.com]
Etiology
(A) CK7 and (B) CK19 staining of percutaneous biopsy of left psoas muscle with tumor cells, confirming metastatic CCA and ruling out alternative malignancies and etiologies. [acgcasereports.gi.org]
The term, which does not specify the etiology, was first used in 1865 by Brinton,1 who considered the lesion to be an advanced stage of gastritis, but did not exclude cancer. [jamanetwork.com]
Etiology LP is generally a sporadic disease but familial cases have been described. Etiology is unknown. [orpha.net]
Her scrutinizing clinical history and examination negated any systemic conditions; while the discrimination between local etiologies rested upon histopathological confirmation. [ccij-online.org]
Epidemiology
A retrospective review of GA patients with LP from the surveillance, epidemiology, and end results database (2004-2009) was performed. 29,440 patients with GA were identified, of whom 948 (3.2%) had LP. [ncbi.nlm.nih.gov]
A retrospective review of GA patients with LP from the surveillance, epidemiology, and end results database (2004‐2009) was performed. 29,440 patients with GA were identified, of whom 948 (3.2%) had LP. [ingentaconnect.com]
Linitis plastica Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Linitis plastica from Other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications [wikidoc.org]
Pathophysiology
Trials.gov US National Guidelines Clearinghouse NICE Guidance FDA on Linitis plastica pathophysiology CDC on Linitis plastica pathophysiology Linitis plastica pathophysiology in the news Blogs on Linitis plastica pathophysiology Directions to Hospitals [wikidoc.org]
Continuing Education Activity This activity reviews the epidemiology, pathophysiology, genetic background, staging, histological assessment, evaluation, treatment, the prognosis of gastric linitis plastica (LP). [ncbi.nlm.nih.gov]
Prevention
Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case #1 Linitis plastica x-ray On the Web Most recent articles Most cited articles Review articles CME Programs Powerpoint slides Images American Roentgen [wikidoc.org]
Rarely diagnosed early, and often disseminating in the peritoneal cavity, LPGC treatments are challenging, summoning measures to contain peritoneal dissemination, and for prevention. [keio.ac.jp]