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]
Immune System
- Splenomegaly
Image Diagnosis: A Gastric Signet-Ring Adenocarcinoma of Type Linitis Plastica Mimicking Splenomegaly in a Patient with Chronic Lymphocytic Leukemia Leonid L Yavorkovsky, MD, PhD; Shazia Ali, MD Perm J 2017;21:16-144 [Full Citation] https://doi.org/10.7812 [thepermanentejournal.org]
Mild splenomegaly, no definite focal lesion. Normal pancreas. Bilateral small renal stones with the largest is left renal lower calyceal = 13 mm. No renal masses or hydronephrosis. No significantly enlarged para-aortic or pelvic lymph nodes. [radiopaedia.org]
Sister Mary Joseph nodule (palpable nodule bulging into the umbilicus) Signs of ascites: Hepatomegaly / splenomegaly / hepatosplenomegaly Flank fullness Shifting dullness (difference in percussion note in the flanks that shifts when the patient is turned [wikidoc.org]
Entire Body System
- Pain
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]
Patients with gastric cancer will present with abdominal pain and weight loss more than 50% of the time. 2 Additional symptoms include nausea, dysphagia, gastrointestinal bleeding (hematemesis, melena), and early satiety. [cancertherapyadvisor.com]
Methods Used Not applicable Summary of Results A 70 year old female admitted for a lower back pain and weight loss. [afmr.org]
A 13-year-old boy presented with peri-umbilical colicky pain for two days. He had constipation and rectal bleeding for one month. There was no family history of similar complaints. [jpgmonline.com]
- 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]
- Lymphadenopathy
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. [ncbi.nlm.nih.gov]
Physical examination of patients with linitis plastica and metastasis may be remarkable for lymphadenopathy, weight loss, and signs of ascites. [wikidoc.org]
The classic example of lymphatic spread is left supraclavicular lymphadenopathy (also known as Virchow's node), which was also seen in our patient later in her clinical course. [journals.lww.com]
A computed tomography scan of the neck, chest, abdomen, and pelvis revealed diffuse lymphadenopathy and no splenomegaly. The patient was diagnosed with Rai stage I, B-cell chronic lymphocytic leukemia (CLL). No treatment was recommended. [thepermanentejournal.org]
- Swelling
Upper gastrointestinal series revealed gastric fold swelling extending from the gastric corpus to the fundus. The patient underwent EUS-FNA (Fig. 4A and B). [journals.lww.com]
The gastric fold swelling was pointed out by the EGD and despite the suspected advanced gastric LP, biopsy indicated Group 1. Repeat biopsy did not suggest malignancy. The patient was referred to our institution. [ncbi.nlm.nih.gov]
- 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]
Respiratoric
- Pneumonia
[…] perovskites Bidisha Nath, Subhendu Kr Panda, Basudev Pradhan Study of JV hysteresis in perovskite solar cells by methylamine vapour treatment Bidisha Nath, Praveen C Ramamurthy, D Roy Mahapatra, Gopalkrishna Hegde HRCT PATTERN IN USUAL INTERSTITIAL PNEUMONIA [eposters.net]
[…] lingual nerve 설신경 6174 lingual root 설측근 6173 lingual tonsil 설편도 6172 linitis plastica 증생성위벽염, 형성성위조직염, 증식성위벽염 6171 lip 입술, 구순 6170 lipid bound proton 지방결합양성자 6169 lipid-laden 지방적재 6168 lipiodol 리피오돌 6167 lipoblast 지방모세포 6166 lipoid 리포이드, 유지질 6165 lipoid pneumonia [radiology.or.kr]
중단된 intersex: 중성, 반음양 intersperse: 군데군데, 점재한, 산재한 interspinous diameter: 극간경 interstitial: 간질성의 interstitial cystitis: 간질성방광염 interstitial density: 간질성음영 interstitial emphysema: 간질성기종 interstitial nodule: 간질성소결절 interstitial opacity: 간질혼탁 interstitial pneumonia [pann.nate.com]
[…] true lumen 진경 spasmolysis 진경약, 진경제, 진경성의 antispasmodic 진골수거핵구 promegakaryocyte 진공 vacuum 진공관 vacuum tube 진균, 곰팡이, 균상종 fungus 진균감염증 mycotic infections 진균성궤양 mycotic ulcer 진균성동맥류 mycotic aneurysm 진균성색전증 mycotic embolism 진균성의, 사상균성의 mycotic 진균성폐렴 mycotic pneumonia [m.blog.naver.com]
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]
Liver, Gall & Pancreas
- Jaundice
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]
Vital Signs Low-grade fever Skin Jaundice is present with liver metastasis. [wikidoc.org]
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]
- Hepatosplenomegaly
Sister Mary Joseph nodule (palpable nodule bulging into the umbilicus) Signs of ascites: Hepatomegaly / splenomegaly / hepatosplenomegaly Flank fullness Shifting dullness (difference in percussion note in the flanks that shifts when the patient is turned [wikidoc.org]
There were 1.5-cm bilateral cervical and axillary lymph nodes but no hepatosplenomegaly. [thepermanentejournal.org]
Skin
- Ulcer
Mucosal nodularity or ulceration. CT may show uniform, nonspecific wall thickening (10-15mm) with loss of rugal folds. [med-ed.virginia.edu]
It is a coincidence that the majority of instances of linitis plastica carcinoma of the colon, in the absence of pre-existing ulcerative colitis, have also been considered clinically as inflammatory disease, specifically ulcerative colitis. [pubs.rsna.org]
Detection of small fibrotic lesion in the gastric wall would contribute to early diagnosis of linitis plastica, since the primary lesion usually lacks remarkable protrusion or ulceration. [ncbi.nlm.nih.gov]
Biopsy from the stomach ulcer revealed poorly differentiated adenocarcinoma with signet ring cells. [indianjrheumatol.com]
ulceration and also the ulcer seen in the image 2 of 43.. [gastrointestinalatlas.com]
- Sweating
Adenoid cystic carcinoma - Familial adenomatous polyposis - Prolactinoma - Oncocytoma - Hurthle cell - Clear cell adenoma/adenocarcinoma - Renal cell carcinoma - Multiple endocrine neoplasia - Endometrioid tumor Adnexal And Skin appendage (8390-8429) sweat [bionity.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]
- Night Sweats
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]
Neurologic
- Irritability
In general, this tumor present with hematuria and irritative symptoms, and may yield equivocal radiologic and cystoscopic findings. [ncbi.nlm.nih.gov]
The effect of new diagnostic criteria for irritable bowel syndrome on community prevalence estimates. Neurogastroenterol Motil,15: 687-694, 2003. 3-Drossman DA; Corrazziari E; Delvaux M. et al. [scla.org.sy]
자극과민성, 과민, 피자극성, 과민성 irritable: 자극성, 흥분성, 과민성 irritable colon: 과민성결장 irritant: 자극물, 자극약, 자극성 irritation: 자극 ischemia: 허혈, 국소빈혈 ischemic: 허혈성의 ischemic colitis: 허혈성대장염 ischemic heart disease: 허혈성 심질환 ischemic necrosis: 허혈성괴사 ischial ramus: 좌골지 ischial [pann.nate.com]
[…] bowel syndrome (irritable colon syndrome)過敏性腸症候群 irritable colon刺激性結腸 j jaundice (icterus)黄疸 jejunum空腸 k ketone bodyケトン体 ketone groupケトン基 l lamina muscularis mucosae粘膜筋板 laparoscope (peritoneoscope)腹腔鏡 laparoscopic cholecystectomy (lapcholy)腹腔鏡下胆嚢摘出術 [tokyo-med.ac.jp]
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]
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]
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]