Non-Hodgkin lymphoma of the stomach: a cause of linitis plastica.
OBJECTIVE
To demonstrate the radiologic appearance of linitis plastica in non-Hodgkin lymphoma of the stomach and to correlate radiologic and pathologic findings.


METHODS
Of 34 cases of non-Hodgkin lymphoma of the stomach in the radiologic archives of the Armed Forces Institute of Pathology, nine had a linitis plastica appearance at barium study. The radiologic, endoscopic, and pathologic findings of these cases were reviewed.


RESULTS
All nine patients (six with primary gastric lymphoma, three with generalized lymphoma with stomach involvement) were symptomatic. Images from barium studies revealed a linitis plastica appearance with narrowing of the gastric antrum and/or body (n = 5), narrowing of the body and/or fundus (n = 3), and diffuse gastric narrowing (n = 1). On CT scans (n = 7), marked circumferential soft-tissue thickening (average thickness, 2.9 cm) of the gastric wall was seen. Patients were treated with subtotal gastrectomy and gastrojejunostomy (n = 5) or total gastrectomy and esophagojejunostomy (n = 4). In all cases, histopathologic specimens revealed a thickened gastric wall with lymphomatous cell infiltration. Wall thickening was associated with areas of fibrosis in only one case.


CONCLUSIONS
Non-Hodgkin gastric lymphoma should be recognized as another cause of linitis plastica, especially in patients with a history of lymphoma or evidence of generalized lymphoma at presentation.
Levine
M S
MS
Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC, USA.
Pantongrag-Brown
L
L
Aguilera
N S
NS
Buck
J L
JL
Buetow
P C
PC
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008039:Linitis Plastica / Q000000981:diagnostic imaging*; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013270:Stomach / Q000000981:diagnostic imaging; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology