Diffuse/infiltrative gastric adenocarcinoma (linitis plastica)

Case contributed by Michael P. Hartung
Diagnosis certain

Presentation

Abdominal discomfort.

Patient Data

Age: 40 years
Gender: Male

Diffuse thickening and enhancement of the stomach wall. 

Gastrohepatic ligament adenopathy. Omental thickening/nodules. Ascites. Few upper abdominal varices. 

Case Discussion

Infiltrative type of gastric adenocarcinoma confirmed at the time of surgery (linitis plastica). 

When differentiating this from gastric wall thickening from inflammation or peptic ulcer disease, notice the degree of soft tissue enhancement of the entire wall. Submucosal edema from inflammation is usually lower in attenuation and enhances less than the mucosa (such as in this case). 

The presence of gastrohepatic ligament adenopathy and carcinomatosis confirms the malignant diagnosis. 

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