Linitis plastica diagnostic study of choice

Revision as of 18:30, 11 January 2018 by Hadeel Maksoud (talk | contribs)
Jump to navigation Jump to search

Linitis plastica Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Linitis plastica from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Staging

Diagnostic study of choice

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Linitis plastica diagnostic study of choice On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Linitis plastica diagnostic study of choice

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Linitis plastica diagnostic study of choice

CDC on Linitis plastica diagnostic study of choice

Linitis plastica diagnostic study of choice in the news

Blogs on Linitis plastica diagnostic study of choice

Directions to Hospitals Treating Linitis plastica

Risk calculators and risk factors for Linitis plastica diagnostic study of choice

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.

Diagnostic study of choice

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. 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.
  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.


Template:WikiDoc Sources