The significance of a nineteenth century definition in the era of genomics: linitis plastica.

BACKGROUND: Linitis plastica due to gastric adenocarcinoma is a condition with a long history, but still lacks a standardized definition and is commonly confused with Borrmann type IV, Lauren diffuse, and signet-cell type gastric cancer. The absence of a clear definition is a problem when investigating its biological characteristics and role as a possible independent factor for prognosis. Nevertheless, the biological behavior for linitis plastica, which is unique, may be valuable in risk stratification and have implications for treatment. A definition of linitis plastica based on molecular or genomic criteria could represent a useful starting point for investigating new targeted therapies. MAIN BODY: This literature review of linitis plastica will focus on the current classifications for gastric cancer, illustrating how the concept of linitis plastica relates to them in most cases and identifying a clear and reproducible definition. Moreover, the review will highlight the diagnostic challenges associated with linitis plastica, its prognostic implications, and the therapeutic options available. Future perspectives for its management are also addressed. CONCLUSION: Linitis plastica is a carcinoma with a scirrhous stroma, involving the submucosal and muscular layers of the stomach even in the absence of mucosal alteration. In most cases, the primary cancer cells are signet-ring cells or scattered cells in the context of a poorly differentiated carcinoma. Diagnosis is challenging. Staging should be thorough, including diagnostic laparoscopy in all cases due to the high incidence of peritoneal involvement. The prognostic significance of linitis plastica is still controversial. Curative-intent surgery, when feasible, should be performed, with a multimodality treatment approach. Cancer-stroma interactions are important features of this disease, and represent attaining potential target for future therapies. Future pathologic assessments of gastric cancer should report the stromal reaction in order to allow better characterization of the tumor.

Primary linitis plastica of the entire colon in a background of ulcerative colitis: a case report.

We present a case report of colorectal cancer arising in a young patient with ulcerative colitis of only 6 years duration. The pathology was unusual with extensive pancolonic involvement in a lintitis plastica fashion. This case represents a clinical example where colon cancer occurred prior to the onset of recommended screening according to guidelines regarding patients with ulcerative colitis.

[Endoscopic and echoendoscopic findings in secondary linitis plastica of the rectum]. / Hallazgos endoscópicos y ecoendoscópicos en la linitis plástica rectal secundaria.

Linitis plastica of the rectum consists of intraparietal, subepithelial and circumferential tumoral infiltration of the wall of the rectum leading to a constricted rectum with mural thickening. There is often a delay between symptom onset and diagnosis because this entity mimics a large number of diseases and the findings of endoscopy and conventional biopsies are non-conclusive since the surface mucosa is not usually affected. We present the endoscopic and echoendoscopic findings of two patients with secondary linitis plastica of the rectum.

[Ileocolic linitis in Crohn's disease]. / Linite iléo-colique au cours d'une maladie de Crohn.

Intestinal cancer is uncommon in Crohn's disease but the risk of developing such a tumor is increased. Linitis plastica of the small bowel or colon is very rare. We report a case of ileocolonic linitis plastica which occurred 21 years after an ileocecal resection for Crohn's disease. Partial small bowel obstruction in relation with stricture of the preanastomotic loop prompted us to suspect disease recurrence. The tumor was not diagnosed either on preoperative work-up, or during surgery but only on the histological examination of the resected specimen. Palliative chemotherapy with 5 FU and folinic acid was performed. The patient was asymptomatic after a 17-month follow-up. This observation focuses on the clinical signs and course of linitis plastica. It also illustrates the difficulty of tumor diagnosis in Crohn's disease. Malignant transformation must be suspected if signs of active disease re-occur after a lengthy quiescent period.

[A case of secondary linitis plastica of the colon developing 14 years after gastrectomy in advanced carcinoma].

A 59-year-old woman was admitted to our hospital complaining of weight loss. Fourteen years earlier, she had undergone gastrectomy for gastric carcinoma of the Borrmann III type on the lesser curvature of the body. Biopsy specimens of the lesion revealed poorly differentiated adenocarcinoma. On the fifth hospital day of the admission under study, she complained of vaginal bleeding, and a diagnosis of endometrial carcinoma was made by a gynecologist. Transverse colectomy and total hysterectomy were done. The lesion was localized only in the transverse colon, was histologically poorly differentiated adenocarcinoma similar to the specimen of gastric carcinoma resected 14 years earlier and involved mainly the serosa. Therefore, secondary linitis plastica of the transverse colon was diagnosed.

[Primary linitis plastica carcinoma of the colon and the rectum. Report of three personal cases (author's transl)]. / Linites plastiques colo-rectales primitives. Revue de la littérature. A propos de trois cas personnels.

Primary linitis plastica carcinoma of the colon is rare. Only 19 cases have previously been described in the american literature and three french cases are reported. Clinically, this entity appears as an inflammatory lesion. It revolves to a stenotic lesion and death by metastases. Eighty-four per cent of carcinomas are beyond the splenic angle and sixty-six per cent are localized on rectum or distal sigmoid. These tumours are accessible to rectoscopic examination and biopsy which is the only examination able to assert the diagnosis of linitis. Histologically, nothing can distinguish a primary colonic localization from a metastasis. Therefore, it is very important to search for a primary localization especially gastric. Surgical resection is efficient with or without X ray-therapy as we have seen it with control of carcino-embryogenic antigene evolution in one of our cases. Prognosis is bad, especially among people over 50 years with metastasis.

Sarcoidosis as a cause of linitis plastica.

We report a patient with gastric sarcoidosis. After initial pulmonary sarcoidosis, which responded to corticosteroids, the patient developed linitis plastica of the stomach which was treated by partial gastrectomy and steroids.

Gastritis flemonosa aguda en un paciente con sida / Acute gastritis flemonosa in a patient with AIDS

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Linitis plástica primaria de colon: aportación de un caso y revisión en la literatura / Primary linitis plastica of the colon: report of a case and review of the literature

El carcinoma con células en anillo de sello es el subtipo histológico menos común de los adenocarcinoma gastrointestinales1. La localización colorrectal es muy poco frecuente, con cifras que oscilan entre el 0,2 y el 2 por ciento de los tumores colorrectales2. El estudio de la forma de presentación, sus características histológicas y la evolución clínica indica que tiene un comportamiento biológico distinto del adenocarcinoma de colon, conllevando importantes implicaciones diagnósticas y terapeúticas (AU)