Linitis plastica pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]
Overview
On gross pathology, thick, rigid, leather bottle-like stomach from diffuse infiltration of the stomach wall by the tumor cells are characteristic findings of linitis plastica.[1] On microscopic histopathological analysis, atypical signet ring cells diffusely infiltrating the stomach wall, submucosal fibrosis and thickening, with minimal mucosal involvement are characteristic findings of linitis plastica.
Pathophysiology
- On gross pathology, thick, rigid, leather bottle-like stomach from diffuse infiltration of the stomach wall by the tumor cells are characteristic findings of linitis plastica.[1]
- On microscopic histopathological analysis, poorly differentiated, atypical signet ring cells diffusely infiltrating the stomach wall, submucosal fibrosis and thickening, with minimal mucosal involvement are characteristic findings of linitis plastica.[2][3]
- As a result of the infiltration and fibrosis, there is diffuse thickening and rigidity of the gastric wall, making the process of digestion difficult.
- Mucosa is usually spared and rarely shows superficial ulcerations on endoscopy, that has a wide differential diagnosis, making the diagnosis even more difficult. The biopsies are usually negative as the disease remains mostly submucosal.[2]
- Although the lower mucosal and submucosal layers are mostly involved, the muscular and subserosal layers may also be infiltrated with the neoplastic cells.[4]
- Metastasis to the peritoneum, lymph nodes and/or other organs usually occurs by the time linitis plastica is diagnosed. Linitis plastica may also occur secondary to metastasis from other primary cancers, particularly infiltrating lobular carcinoma of breast.[5]
- CDH1 (E-cadherin) gene may be involved in the pathogenesis of hereditary form of diffuse gastric adenocarcinoma.[6]
References
- ↑ 1.0 1.1 Linitis plastica. Wikipedia. https://en.wikipedia.org/wiki/Linitis_plastica Accessed on November 18, 2015.
- ↑ 2.0 2.1 Schauer, M; Peiper, M; Theisen, J; Knoefel, W (2011). "Prognostic factors in patients with diffuse type gastric cancer (linitis plastica) after operative treatment". European Journal of Medical Research. 16 (1): 29. doi:10.1186/2047-783X-16-1-29. ISSN 2047-783X.
- ↑ Stomach cancer. Wikipedia. https://en.wikipedia.org/wiki/Stomach_cancer Accessed on November 19, 2015.
- ↑ Bing Hu, Nassim El Hajj, Scott Sittler, Nancy Lammert, Robert Barnes & Aurelia Meloni-Ehrig (2012). "Gastric cancer: Classification, histology and application of molecular pathology". Journal of gastrointestinal oncology. 3 (3): 251–261. doi:10.3978/j.issn.2078-6891.2012.021. PMID 22943016. Unknown parameter
|month=ignored (help) - ↑ Gastric linitis plastica. Orphanet. http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=36273 Accessed on December 7, 2015.
- ↑ Gastric linitis plastica. Orphanet. http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=36273 Accessed on November 19, 2015.