A Leathery Lining
A 44-year-old previously healthy man from Mexico presented with 10 days of abdominal pain, nausea, and vomiting. The exam was remarkable for decreased left-sided breath sounds, diffuse abdominal tenderness, and mild abdominal distention. Chest radiograph showed a large left pleural effusion. Computed tomography of the abdomen demonstrated a markedly thickened stomach wall, loculated peritoneal fluid collections, paraaortic lymphadenopathy, and omental carcinomatosis (Fig. 1). Thoracentesis was performed and cytopathological examination of the pleural fluid showed a poorly differentiated adenocarcinoma of upper gastrointestinal origin. Esophagogastroduodenoscopy revealed a diffusely thickened and rigid stomach indicating extensive intramural malignant infiltration consistent with “linitis plastica” (Fig. 2); gastric biopsy confirmed diffuse-type gastric adenocarcinoma.Figure 1.
- Wanebo HJ, et al. Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg. 1993;218(5):583–92. CrossRef
- Hamy A, et al. Study of survival and prognostic factors in patients undergoing resection for gastric linitis plastica: a review of 86 cases. Int Surg. 1999;84(4):337–43.
- Armstrong GE. Linitis plastica. Can Med Assoc J. 1914;4(9):770–5.
- A Leathery Lining
Journal of General Internal Medicine
Volume 29, Issue 1 , p 243
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
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- Linitis plastica
- gastric cancer
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- 2. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
- 3. Division of Hospital Medicine, University of California, San Francisco, 533 Parnassus, U 113, Box 0131, San Francisco, CA, 94143, USA