![]() The folds of the gastric antrum were flexible, stretched smoothly, and crossed one another, resulting in a waffle-like appearance on the greater curvature of the upper gastric body ( Fig. The upper gastric body, however, demonstrated good extension when compared with the middle and lower gastric bodies. 2A) and severe luminal narrowing, with poor distension of the lower gastric body. Additionally, endoscopy revealed an ulcerative lesion covered by a white necrotic substance on the posterior wall of the antrum ( Fig. In addition, the lower gastric body demonstrated luminal narrowing and increased rigidity, with a depressed lesion (longest diameter, 20 mm) at the posterior wall of the gastric antrum and abdominal computed tomography revealed thickening of the antrum. However, X-ray examination indicated reduced gastric distension, as well as deformation of the stomach, which exhibited a leather bottle-like appearance ( Fig. ![]() Serum concentrations of the tumor markers, carcinoembryonic antigen and carbohydrate antigen 19-9, were within the normal ranges (<5 ng/ml and 0–37 U/ml, respectively). Furthermore, pretibial edema was not observed and superficial lymph nodes were not palpable. On palpation, the abdomen of the patient was soft and flat, with no areas of tenderness. Physical examination upon admission revealed no anemia (via conjunctival pallor examination), jaundice or pulmonary abnormalities. The patient had a history of hypertension and obstructive sleep apnea syndrome. Written informed consent was obtained from the patient.Ī 66-year-old female was admitted to Kagawa University Hospital (Kagawa, Japan) with the complaint of intermittent epigastric pain that was exacerbated by fasting. The present report describes a patient with linitis plastica-type gastric cancer, in whom the characteristic morphological changes in the folds of the gastric body facilitated the determination of the spread and depth of tumor invasion. Linitis plastica-type gastric cancer tumors tend to infiltrate the submucosa and muscularis propria of the gastric wall, thus, superficial mucosal biopsies may be falsely negative, and detecting the extent of the spread and depth of the linitis plastica-type gastric cancer can be difficult endoscopically. Since the majority of linitis plastica patients are diagnosed at an advanced stage of the disease, clinical outcomes are commonly observed, regardless of the extent or type of primary resection that may have been performed ( 2). Linitis plastica is defined as a gastric cancer of diffuse histotype ( 1) that presents in the fundic gland area, and is characterized by thickening of the stomach wall resulting in deformation of the stomach and a leather bottle-like appearance. ![]() ![]() Therefore, the present report recommends that the diagnosis of the spread of linitis plastica-type gastric cancer should include assessments of the primary lesion, as well as evaluation of morphological changes in the gastric folds. Subsequent pathological findings demonstrated that the tumor had spread from the primary lesion to the upper gastric body. Morphological changes in the gastric folds indicated that the tumor had invaded the upper gastric body, therefore, a total gastrectomy was performed. Analysis of biopsy specimens from the depressed lesion revealed a poorly differentiated adenocarcinoma. Endoscopy indicated a depressed lesion in the gastric antrum, and abnormal folds, which crossed to form a waffle-like appearance in the upper gastric body. X-ray examination revealed reduced gastric distension and deformation of the stomach, which exhibited a leather bottle-like appearance. A 66-year-old female was admitted to Kagawa University Hospital (Kagawa, Japan) with epigastric pain. Linitis plastica is a gastric cancer of diffuse histotype that presents in the fundic gland area, and is characterized by thickening of the stomach wall and deformation of the stomach, resulting in a leather bottle-like appearance.
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