Small cell carcinomas are the most aggressive, highly malignant neuroendocrine tumors; among these, gastric small cell carcinoma (GSCC) is extremely rare. Here we report a case of a patient with primary GSCC, presenting as linitis plastic, who was diagnosed using endoscopic ultrasound (EUS)-guided biopsy. With undiagnosed linitis plastica, an 80-year-old woman was referred to our institution. Abdominal computed tomography revealed irregular wall thickening extending from the gastric body to the antrum. Endoscopy suspected to have Borrmann type IV advanced gastric cancer. EUS of the stomach showed diffuse submucosal thickening of the gastric wall, mainly the antrum. EUS-guided bite-on-bite biopsy confirmed the diagnosis of GSCC. In general, GSCC is difficult to diagnose and careful examination is necessary to determine the therapeutic strategy; however, EUS is particularly helpful in the differential diagnosis of a lesion presenting as linitis plastica.
Aged, 80 and over ; Biopsy ; Carcinoma, Small Cell ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Endosonography ; Female ; Humans ; Linitis Plastica ; Neuroendocrine Tumors ; Plastics ; Stomach ; Stomach Neoplasms ; Ultrasonography

Gastric metastasis from invasive lobular breast carcinoma is rare. Mostly gastrointestinal metastasis presents as one among multiple metastases, several years after primary diagnosis of breast carcinoma. Herein, we report a synchronously diagnosed gastric metastasis from invasive lobular carcinoma, mimicking primary gastric linitis plastica with pyloric obstruction. We reviewed clinical and pathological findings of gastric carcinoma metastatic from the breast. In particular, we focused on immunohistochemical studies of selected antibodies, including those for estrogen receptors, gross cystic disease fluid protein-15, and caudal-type homeobox transcription factor 2, for accurate differential diagnosis. Clinical suspicion, repeat endoscopic biopsy, and detailed histological analysis including immunohistochemistry are necessary for diagnosis of gastric carcinoma metastatic from the breast.
Antibodies ; Biopsy ; Breast Neoplasms* ; Breast* ; Carcinoma, Lobular ; Diagnosis ; Diagnosis, Differential ; Genes, Homeobox ; Immunohistochemistry ; Linitis Plastica ; Neoplasm Metastasis* ; Receptors, Estrogen ; Stomach ; Transcription Factors

Early diagnosis of Borrmann type 4 advanced gastric cancer (AGC) is very important for improving the prognosis of AGC patients. Because there is no definite mass in most cases of Borrmann type 4 AGC, its accurate diagnosis via endoscopy requires an understanding of its pathogenesis and developmental process. Moreover, many people confuse linitis plastica (LP) type gastric cancer (GC), scirrhous GC, and Borrmann type 4 AGC. To distinguish each of these cancers, knowledge of their endoscopic and pathological differences is necessary, especially for LP type GCs in the developmental stage. In conclusion, diagnosis of pre-stage or latent LP type GC before progression to typical LP type GC requires the detection of IIc-like lesions in the fundic gland area. It is also crucial to identify any abnormalities such as sclerosis of the gastric wall and hypertrophy of the mucosal folds during endoscopy.
Diagnosis ; Early Diagnosis ; Endoscopy ; Humans ; Hypertrophy ; Linitis Plastica ; Prognosis ; Sclerosis ; Stomach Neoplasms*

Breast cancer metastases to the gastrointestinal tract are very rare occurrences. Among the histological subtypes of breast cancer, invasive lobular carcinomas have a high capacity of metastasis to uncommon sites including the stomach. Conversely, there has not been sufficient evidence supporting the gastric metastasis of invasive ductal carcinoma. Herein, we report a unique case of metastatic ductal breast carcinoma mimicking primary linitis plastica in a male patient, particularly focusing on the clinical and pathological features of presentation. Moreover, we propose a immunohistochemical panel of selected antibodies including those for cytokeratin 20, cytokeratin 7, estrogen receptor, progesterone receptor, E-cadherin, gross cystic disease fluid protein 15, and GATA binding protein 3 for an accurate differential diagnosis.
Antibodies ; Biomarkers ; Breast Neoplasms* ; Breast* ; Cadherins ; Carcinoma, Ductal ; Carcinoma, Lobular ; Carrier Proteins ; Diagnosis, Differential ; Estrogens ; Gastrointestinal Tract ; Humans ; Keratin-20 ; Keratin-7 ; Linitis Plastica* ; Male* ; Neoplasm Metastasis ; Receptors, Progesterone ; Stomach*

Gastric cancer is the second leading cause of cancer related death in the world. In United States, gastric polyps are found in approximately 6% of upper endoscopy. The incidence of gastric polyps increased with widespread use of esophagogastroduodenoscopy and more liberal use of proton pump inhibitors. They are usually asymptomatic, but infrequently cause symptoms of bleeding, pain and gastric outlet obstruction. It is important to distinguish premalignant conditions and mimickers of malignancy. Helicobacter pylori eradication therapy leads to regression of hyperplastic polyps but it is not clear for adenoma. Endoscopy plays key role not only in diagnosis but also in surveillance. With narrow band imaging and chromo endoscopy, we are much better today in detecting and discerning these. Also, with endoscopic mucosal resection and endoscopic submucosal dissection, we can manage these better. In this review article we will discuss the various diagnostic tools and therapeutic options for hyperplastic polyp, fundic gland polyp, gastrointestinal stromal tumor, adenoma, neuroendocrine tumor, linitis plastica, and intestinal metaplasia.
Adenoma ; Carcinoid Tumor ; Diagnosis ; Endoscopy ; Endoscopy, Digestive System ; Endosonography ; Gastric Outlet Obstruction ; Gastrointestinal Stromal Tumors ; Helicobacter pylori ; Hemorrhage ; Incidence ; Linitis Plastica ; Metaplasia ; Narrow Band Imaging ; Neuroendocrine Tumors ; Polyps* ; Proton Pump Inhibitors ; Stomach Neoplasms ; United States

Gastric cancer is rare during pregnancy, and often advanced upon presentation. A Krukenberg tumor presents a diagnostic and therapeutic challenge in the pregnant patient. We present a case of a 38-year-old woman at 22 weeks' gestation who presented with worsening epigastric pain, and was found to have a left pelvic mass on ultrasound, which was confirmed by magnetic resonance imaging. She went into active labor and delivered a viable infant via vaginal delivery. An exploratory laparotomy revealed a large mass originating from her left ovary and diffuse thickening of the lesser curvature of the stomach. Frozen section investigation revealed the presence of signet cell adenocarcinoma. Subsequent upper endoscopy showed linitis plastica, while biopsy confirmed the presence of adenocarcinoma. In conclusion, the occurrence of gastric cancer in pregnancy is rare despite extremely common symptoms. The management poses a challenge because of the need for early treatment, and the continuation of the pregnancy.
Adenocarcinoma ; Adult ; Biopsy ; Endoscopy ; Female ; Frozen Sections ; Humans ; Infant ; Krukenberg Tumor* ; Laparotomy ; Linitis Plastica ; Magnetic Resonance Imaging ; Ovary ; Pregnancy* ; Stomach ; Stomach Neoplasms* ; Ultrasonography

Amyloidosis is a group of disorders characterized by the extracellular accumulation of insoluble, fibrillar proteins in various organs and tissues. It is classified, on the basis of the identity of the precursor protein, as primary, secondary, or familial amyloidosis. Gastrointestinal amyloidosis usually presents as bleeding, ulceration, malabsorption, protein loss, and diarrhea. However, gastric amyloidosis with gastric outlet obstruction mimicking linitis plastica is rare. We report a case of gastrointestinal amyloidosis with gastric outlet obstruction in a patient with ankylosing spondylitis. The patient was indicated for subtotal gastrectomy because of the aggravation of obstructive symptoms, but refused the operation and was transferred to another hospital. Three months later, the patient died of aspiration pneumonia during medical treatment.
Amyloidosis* ; Amyloidosis, Familial ; Diarrhea ; Gastrectomy ; Gastric Outlet Obstruction* ; Hemorrhage ; Humans ; Linitis Plastica ; Pneumonia, Aspiration ; Spondylitis, Ankylosing* ; Ulcer

Mantle cell lymphoma has a broad spectrum of endoscopic presentations, such as thick, rigid folds that are indispensible on air insufflation, superficial confluent ulceration, or a polypoidal mass protruding into the lumen. The exact diagnosis is difficult to make because the lesion is in the submucosal layer and inaccessible by biopsy. Lesions will often exfoliate necrotic cells which make interpretation difficult, or they may be too small in number and size and thus indistinguishable from anaplastic carcinoma. We report a case of mantle cell lymphoma with diffuse wall thickening of the whole stomach in a 51-year-old man. The series of endoscopic findings in this case support the role of differential diagnosis of linitis plasica type of advanced gastric cancer with mantle cell lymphoma.
Biopsy ; Carcinoma ; Diagnosis, Differential ; Humans ; Insufflation ; Linitis Plastica ; Lymphoma, Mantle-Cell ; Middle Aged ; Stomach ; Stomach Neoplasms ; Ulcer

Eosinophilic gastroenteritis is an unusual disease that is associated with various clinical gastrointestinal manifestations. Its severity depends on the area involved as well as the wall layer involved. Eosinophilic gastroenteritis often causes abdominal pain, nausea, vomiting and diarrhea. To date, there has been an extremely rare case of eosinophilic gastroenteritis with systemic symptoms, such as fever or lymphadenopathy (LAP). We experienced a case of a 68-year-old-woman with fever and abdominal pain. Abdominal computed tomography revealed diffuse wall thickening of the gastric antrum as linitis plastica. Multiple hot uptakes of lymph nodes were visualized on fludeoxyglucose-positron emission tomography. The gastric biopsy pathological report demonstrated eosinophilic infiltration without malignant cells. We could not exclude malignancy and performed an exploratory laparoscopy. A lymph node specimen showed reactive hyperplasia, and her illness was finally diagnosed as eosinophilic gastroenteritis. Herein, we report the case with a brief review.
Abdominal Pain ; Biopsy ; Diarrhea ; Enteritis ; Eosinophilia ; Eosinophils ; Fever ; Gastritis ; Gastroenteritis ; Hyperplasia ; Laparoscopy ; Linitis Plastica ; Lymph Nodes ; Lymphatic Diseases ; Nausea ; Pyloric Antrum ; Vomiting

Adenocarcinoma is the most common pathologic diagnosis, representing >95% of colorectal cancers; mucinous adenocarcinoma (MA) accounts for 10-15% and SRC accounts for 0.1-2.4% of colorectal cancers. MA is defined as a tumor with > or =50% mucin. Patients with MAs have a poor prognosis, a higher proportion of peritoneal metastases, and present at a more advanced stage of disease. Linitis plastica involving the colon and rectum is usually a metastatic lesion from gastric cancer and other organs, such as the prostate, gallbladder, and breast. Primary linitis plastica of the colon is very rare. We managed a case of colon cancer occurring in a 19-year-old female with a histologic diagnosis of mucinous adenocarcinoma and morphologic features of linitis plastica. Herein we report a rare case of primary linitis plastica of the colon with a review of the literature.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Breast ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Gallbladder ; Humans ; Linitis Plastica ; Mucins ; Neoplasm Metastasis ; Prognosis ; Prostate ; Rectum ; Stomach Neoplasms ; Young Adult