Gastric linitis plastica with metastases to the colon: a mimic of Crohn's disease.
A 60-year-old woman had progressive lower abdominal pain, nonbloody diarrhea, and weight loss, followed by severe epigastric pain and dysphagia. Radiographic evaluation of the colon showed segmental strictures which were interpreted as Crohn's disease. Medical treatment was not helpful. Neither gross endoscopic appearance nor multiple biopsies of the esophagus, stomach, and colon were diagnostic. Finally, laparotomy with full-thickness biopsies of the stomach and colon revealed linitis plastica. The clinician should be alert to colonic metastases from gastric linitis plastica, for it can produce focal or segmental strictures, mimicking more common colonic diseases such as Crohn's disease. A full-thickness biopsy is often necessary for a firm diagnosis. We review the literature on this occurrence, highlighting the clinical and radiologic spectrum, as well as the organ systems most often affected when gastric linitis plastica metastasizes.
Katon
R M
RM
Department of Medicine, Oregon Health Sciences University, Portland 97201.
Brendler
S J
SJ
Ireland
K
K
D002293:Adenocarcinoma, Scirrhous / Q000556:secondary*; D003106:Colon / Q000473:pathology; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D003424:Crohn Disease / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008039:Linitis Plastica / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D011859:Radiography; D013274:Stomach Neoplasms