Linitis plastica diagnostic study of choice: Difference between revisions

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Revision as of 18:29, 11 January 2018

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

Overview

There is no single diagnostic study of choice for the diagnosis of linitis plastica, but linitis plastica can be diagnosed based on upper gastrointestinal endoscopy (upper GI endoscopy) and barium swallow studies. Linitis plastica is often missed on upper GI endoscopies, it is imperative that bite and strip biopies are carried out in order to prevent false negatives. Barium study may be superior to upper GI endoscopy in the case of diffuse adenocarcinoma of the stomach, as a lack of distensibility and flask-shaped appearance of the stomach may be detected.

Gold standard/Study of choice:

There is no single diagnostic study of choice for the diagnosis of linitis plastica, but linitis plastica can be diagnosed based on upper gastrointestinal endoscopy (upper GI endoscopy) and barium swallow.^[1]

Diagnostic results

The following result of upper GI endoscopy is confirmatory of linitis plastica:^[1]

Signet ring cells seen with bite and strip biopsies

The following result of barium study is confirmatory of linitis plastica:

Leather-flask appearance of the stomach with a lack of distensibility

Sequence of Diagnostic Studies

The upper GI endoscopy should be performed when:^[2]

The patient presented with symptoms of weight loss, anorexia and early satiety as the first step of diagnosis.
A positive biopsy is detected in the patient, to confirm the diagnosis.
However, the upper GI endoscopy may give a false negative result in the case of linitis plastica.
Therefore, bite and strip biopsies must be carried out to minimize the occurence of false negatives.
If diffuse adenocarcinoma is suspected, then barium study may be superior to upper GI endoscopy in this instance.
An indistensible, leather bottle appearance of the stomach is detected in the patient, to confirm the diagnosis.

Diagnostic Criteria

There are no established criteria for the diagnosis of linitis plastica.

References

↑ ^1.0 ^1.1 Graham DY, Schwartz JT, Cain GD, Gyorkey F (1982). "Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma". Gastroenterology. 82 (2): 228–31. PMID 7054024.
↑ Karita M, Tada M (1994). "Endoscopic and histologic diagnosis of submucosal tumors of the gastrointestinal tract using combined strip biopsy and bite biopsy". Gastrointest. Endosc. 40 (6): 749–53. PMID 7859977.

Template:WikiDoc Sources

[pmid7054024-1] 1.0 ^1.1 Graham DY, Schwartz JT, Cain GD, Gyorkey F (1982). "Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma". Gastroenterology. 82 (2): 228–31. PMID 7054024.

[pmid7859977-2] Karita M, Tada M (1994). "Endoscopic and histologic diagnosis of submucosal tumors of the gastrointestinal tract using combined strip biopsy and bite biopsy". Gastrointest. Endosc. 40 (6): 749–53. PMID 7859977.

[1]

[2]

@@ Line 4: / Line 4: @@
 == Overview ==
-* The page name should be '''"[Disease name] diagnostic study of choice"''', with only the first letter of the title capitalized. Note that the page is called "Diagnostic study of choice."
+There is no single diagnostic study of choice for the diagnosis of linitis plastica, but linitis plastica can be diagnosed based on upper gastrointestinal endoscopy (upper GI endoscopy) and barium swallow studies. Linitis plastica is often missed on upper GI endoscopies, it is imperative that bite and strip biopies are carried out in order to prevent false negatives. Barium study may be superior to upper GI endoscopy in the case of diffuse adenocarcinoma of the stomach, as a lack of distensibility and flask-shaped appearance of the stomach may be detected.
-* '''Goal:'''
-**To describe the most efficient/sensitive/specific test that is utilized for diagnosis of [disease name].
-**To describe the gold standard test for the diagnosis of [disease name].
-**To describe the diagnostic criteria, which may be based on clinical findings, physical exam signs, pathological findings, lab findings, findings on imaging, or even findings that exclude other diseases.
-* As with all microchapter pages linking to the main page, at the top of the edit box put <nowiki>{{CMG}}</nowiki>, your name template, and the microchapter navigation template you created at the beginning.
-* Remember to create links within WikiDoc by placing <nowiki>[[square brackets]]</nowiki> around key words which you want to link to other pages. Make sure you makes your links as specific as possible. For example, if a sentence contained the phrase anterior spinal artery syndrome, the link should be to [[anterior spinal artery syndrome]] not [[anterior]] or [[artery]] or [[syndrome]].  For more information on how to create links, click [[here]].
-* Remember to follow the same format and capitalization of letters as outlined in the template below.
-* You should include the name of the disease in the first sentence of every subsection.
-== Diagnostic Study of Choice ==
-===== Template statements =====
 === Gold standard/Study of choice: ===
-* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
+There is no single diagnostic study of choice for the diagnosis of linitis plastica, but linitis plastica can be diagnosed based on upper gastrointestinal endoscopy (upper GI endoscopy) and barium swallow.<ref name="pmid7054024">{{cite journal |vauthors=Graham DY, Schwartz JT, Cain GD, Gyorkey F |title=Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma |journal=Gastroenterology |volume=82 |issue=2 |pages=228–31 |year=1982 |pmid=7054024 |doi= |url=}}</ref>
-* The following result of [gold standard test] is confirmatory of [disease name]:
-** Result 1
-** Result 2
-* The [name of investigation] should be performed when:
-** The patient presented with symptoms/signs 1. 2, 3.
-** A positive [test] is detected in the patient.
-* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
-* The diagnostic study of choice for [disease name] is [name of investigation].
-* There is no single diagnostic study of choice for the diagnosis of [disease name].
-* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
-* [Disease name] is mainly diagnosed based on clinical presentation.
-* Investigations:
-** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
-** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
-** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
-==== The comparison table for diagnostic studies of choice for [disease name] ====
-{|
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-! style="background: #FFFFFF; color: #FFFFFF; text-align: center;" |
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
-|-
-! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-|-
-! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
-|}
-<small> ✔= The best test based on the feature </small>
 ===== Diagnostic results =====
-The following result of [investigation name] is confirmatory of [disease name]:
+The following result of upper GI endoscopy is confirmatory of linitis plastica:<ref name="pmid7054024">{{cite journal |vauthors=Graham DY, Schwartz JT, Cain GD, Gyorkey F |title=Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma |journal=Gastroenterology |volume=82 |issue=2 |pages=228–31 |year=1982 |pmid=7054024 |doi= |url=}}</ref>
-* Result 1
+* Signet ring cells seen with bite and strip biopsies
-* Result 2
+The following result of barium study is confirmatory of linitis plastica:
+* Leather-flask appearance of the stomach with a lack of distensibility
 ===== Sequence of Diagnostic Studies =====
-The [name of investigation] should be performed when:
+The upper GI endoscopy should be performed when:<ref name="pmid7859977">{{cite journal |vauthors=Karita M, Tada M |title=Endoscopic and histologic diagnosis of submucosal tumors of the gastrointestinal tract using combined strip biopsy and bite biopsy |journal=Gastrointest. Endosc. |volume=40 |issue=6 |pages=749–53 |year=1994 |pmid=7859977 |doi= |url=}}</ref>
-* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
+*The patient presented with symptoms of weight loss, anorexia and early satiety as the first step of diagnosis.
-* A positive [test] is detected in the patient, to confirm the diagnosis.
+*A positive biopsy is detected in the patient, to confirm the diagnosis.
+*However, the upper GI endoscopy may give a false negative result in the case of linitis plastica.
+*Therefore, bite and strip biopsies must be carried out to minimize the occurence of false negatives.
+*If diffuse adenocarcinoma is suspected, then barium study may be superior to upper GI endoscopy in this instance.
+*An indistensible, leather bottle appearance of the stomach is detected in the patient, to confirm the diagnosis.
 === Diagnostic Criteria ===
-* Here you should describe the details of the diagnostic criteria.
+There are no established criteria for the diagnosis of linitis plastica.
-*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
-*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
-*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
-*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
-*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
-*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
-*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
-* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
-* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
-* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
-* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
-* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
-** Criteria 1
-** Criteria 2
-** Criteria 3
-IF there are clear, established diagnostic criteria:
-*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
-*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
-*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
-IF there are no established diagnostic criteria:
-*There are no established criteria for the diagnosis of [disease name].
 ==References==