Linitis plastica other diagnostic studies: Difference between revisions

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{{Linitis plastica}}
{{Linitis plastica}}
{{CMG}}{{AE}} {{STM}}
{{CMG}};{{AE}}{{HM}}


==Overview==
==Overview==
On upper GI [[endoscopy]], linitis plastica may show superficial [[ulcers]] and/or [[inflammation]]. On [[endoscopic ultrasound]], abnormal thickening of the stomach wall is a characteristic finding.<ref name=oo>Gastric linitis plastica. Orphanet. http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=36273 Accessed on December 9, 2015.</ref>


==Upper GI Endoscopy==
Brush cytology may be helpful in the diagnosis of linitis plastica. Brush cytology has the ability to increase the sensitivity of even a single biopsy carried out by endoscopic ultrasound. If bleeding is a concern in the patient, brush cytology is able to take samples of the mucosa without bleeding. Immunohistochemical staining then confirms the diagnosis of linitis plastica with the finding of signet ring cells.
*[[Esophagogastroduodenoscopy]] ([[EGD]]) or upper GI endoscopy with multiple deep tissue biopsies is performed to confirm the diagnosis of linitis plastica.<ref name="pmid25435971">{{cite journal| author=Maeda E, Oryu M, Tani J, Miyoshi H, Morishita A, Yoneyama H et al.| title=Characteristic waffle-like appearance of gastric linitis plastica: A case report. | journal=Oncol Lett | year= 2015 | volume= 9 | issue= 1 | pages= 262-264 | pmid=25435971 | doi=10.3892/ol.2014.2688 | pmc=PMC4246919 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25435971  }} </ref>
 
**[[Mucosa]] is usually spared. It may look innocent or show superficial ulcers with inflammatory changes as seen in [[gastritis]], thus masking the [[malignant]] nature of linitis plastica. The disease being potentially in the [[submucosa]] and muscularis propria layers, mucosal biopsies are falsely negative.
 
**[[Endoscopic ultrasound]] guided [[fine needle aspiration]] aids in the diagnosis of linitis plastica.<ref name="pmid20214236">{{cite journal| author=Mastoraki A, Papanikolaou IS, Sakorafas G, Safioleas M| title=Facing the challenge of managing linitis plastica--review of the literature. | journal=Hepatogastroenterology | year= 2009 | volume= 56 | issue= 96 | pages= 1773-8 | pmid=20214236 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20214236  }} </ref>
==Other Diagnostic Studies==
*Endoscopic ultrasound may be also performed to understand the depth of tumor invasion as well as spread of the disease to the adjacent structures. 
*Brush cytology with immunohistochemical staining may be helpful in the diagnosis of linitis plastica.<ref name="pmid2028694">{{cite journal |vauthors=Wang HH, Jonasson JG, Ducatman BS |title=Brushing cytology of the upper gastrointestinal tract. Obsolete or not? |journal=Acta Cytol. |volume=35 |issue=2 |pages=195–8 |year=1991 |pmid=2028694 |doi= |url=}}</ref>  
**A 10-20mm thickening of the [[submucosa]]l layer is usually present.<ref name=oo>Gastric linitis plastica. Orphanet. http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=36273 Accessed on December 9, 2015.</ref>
*Brush cytology has the following advantages:
**No risk of bleeding
**Increased sensitivity of single biopsy
**Sensitive to poorly differentiated linits plastica
 


==References==
==References==

Revision as of 21:03, 11 January 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

Brush cytology may be helpful in the diagnosis of linitis plastica. Brush cytology has the ability to increase the sensitivity of even a single biopsy carried out by endoscopic ultrasound. If bleeding is a concern in the patient, brush cytology is able to take samples of the mucosa without bleeding. Immunohistochemical staining then confirms the diagnosis of linitis plastica with the finding of signet ring cells.


Other Diagnostic Studies

  • Brush cytology with immunohistochemical staining may be helpful in the diagnosis of linitis plastica.[1]
  • Brush cytology has the following advantages:
    • No risk of bleeding
    • Increased sensitivity of single biopsy
    • Sensitive to poorly differentiated linits plastica


References

  1. Wang HH, Jonasson JG, Ducatman BS (1991). "Brushing cytology of the upper gastrointestinal tract. Obsolete or not?". Acta Cytol. 35 (2): 195–8. PMID 2028694.


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