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Gastrointestinal Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Gareth Davies, Chris Black, Keeley Fairbrass
This section focuses on gastric adenocarcinoma (90% of gastric cancers): other types are lymphomas, gastro intestinal stromal tumours (GISTs) and carcinoid. Local invasion is common, with early spread to regional and distant lymph nodes, liver, lungs, brain and bones. Widespread submucosal involvement with a rigid stomach is termed linitis plastica. Presentation is usually late, and survival rates are poor.
Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Appearances of the stomach are difficult to assess on CT; however, the diffuse thickening and small lumen along with perigastric fat stranding, ascites and upper abdominal lymphadenopathy is highly suspicious of malignancy, specifically linitis plastica. Linitis plastica can have multiple causes including malignancy, inflammation and infection. The most common cause is scirrhous adenocarcinoma of the stomach. This often causes submucosal infiltration and hence endoscopic biopsies are frequently negative; therefore a repeat may not yield any further information.
Observing and Describing Disease
Published in Jeremy R. Jass, Understanding Pathology, 2020
The Greeks added –osis to words to create a noun out of a verb denoting an action or process. Most disease terms ending in –osis are non-inflammatory and often generalised processes, whereas –it is indicates an inflammatory mechanism. There are exceptions. The tubercles or granulomas of tuberculosis were once thought to be tumours and not inflammatory lesions. We also have aspergillosis and brucellosis. Conversely, diffuse or leather-bottle gastric cancer was thought to be an inflammatory process by early microscopists, hence the term linitis plastica.
Primary extranodal jejunal diffuse large B cell lymphoma as a diagnostic challenge for intractable emesis: a case report and review of literature
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Linda P Vien, Ashish Bains, Ho-Man Yeung
The acuity of intractable emesis and the nonspecific symptoms of abdominal pain and decreased oral intake without any radiographic evidence of obstruction, as in this case, presented itself as a diagnostic challenge. The cause was initially attributed to gastroenteritis with post-infectious gastroparesis; however, the prolonged hospitalization with lack of symptomatic improvement suggested an alternate underlying cause. Although several factors including his age, radiographic findings of linitis plastica and ascites were highly suggestive of a malignant process, extensive workup did not directly point to a specific diagnosis. The initial CT of the abdomen and pelvis with intravenous contrast commented on mild ileus and diffuse wall thickening and mesenteric edema and abdominal pelvic ascites, but it did not reveal any obstructive masses or enlarged lymph nodes. These findings reassured the clinician and led to an initial diagnosis of gastroenteritis.
An updated review on primary signet-ring cell carcinoma of the urinary bladder and report of a case
Published in Scandinavian Journal of Urology, 2018
Maria Elisabeth Lendorf, Line Hammer Dohn, Bara Á Dunga, Anand C. Loya, Helle Pappot
At cystoscopy, an exophytic tumor will appear in two-thirds of cases, according to literature reports. The lesions are described with morphology ranging from polypoid, pedunculated or sessile to ulceroinfiltrative [4,12]. In other cases, e.g. the linitis plastica-like variant, a low-compliance bladder is described with a thickened or fibrotic wall revealing no mucosal or mass lesion. Instead, areas of bullous edema are found [4,11]. In the linitis plastica-like variant, patients tend to present with advanced disease [4]. This histological variant rapidly infiltrates the submucosa and lacks obvious mucosal lesions in the early stage, which makes early diagnosis of this tumor an unlikely event [13,18,32].
Tumor-associated trypsin inhibitor (TATI) and tumor-associated trypsin-2 (TAT-2) predict outcomes in gastric cancer
Published in Acta Oncologica, 2020
Aaro Kasurinen, Alli Laitinen, Arto Kokkola, Ulf-Håkan Stenman, Camilla Böckelman, Caj Haglund
The expression of trypsinogen using gastric cancer cells was previously shown to associate with invasive growth [17,21]. Here, we showed in a clinical setting that a high serum TAT-2 associated with pT3–4 gastric tumors and a poor outcome, providing evidence of TAT-2’s importance in tumor invasion. Similarly, gastric cancer patients’ high serum trypsinogen levels were previously shown to associate with a linitis plastica–type cancer, known for its poor prognosis due to its extremely invasive method of growth [20].