Some specific radiological findings and consideration of linitis plastica of the gastrointestinal tract

Abstract

Linitis plastica denotes a diffuse, intramurally infiltrating, anaplastic carcinoma in a hollow structure resulting in a shrunken organ with thickened walls. Microscopically, linitis plastica is characterized by tumor cells in the presence of inflammatory changes with much fibrosis. Linitis plastica is found most frequently in the stomach where it may produce the classical "leather-bottle stomach". Metastases to the colon are frequent via contiguity along mesenteric fascial planes. Therefore, when linitis plastica carcinoma of the stomach or colon is found, the other organ must also be carefully examined. Although rare, primary linitis plastica carcinoma can occur in the colon where it is often characterized by a long stenotic lesion without irritability, sometimes appearing more like an inflammatory lesion than a carcinoma. While the radiological features are not diagnostic, they are, in many cases, suggestive of this entity. The entire spectrum of linitis plastica is reviewed in relationship to the gastrointestinal tract, synthesizing the pertinent literature, with correlation of clinical, pathophysiological, and specific radiological findings.