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• W2046391159 abstract "Infiltrating neoplasms of the stomach can present considerable difficulty in radiologic diagnosis. It is not always possible to demonstrate easily the presence of a mass, ulceration, or rigidity of the gastric wall, signs which are considered our most useful diagnostic aids. We have recently observed 2 cases in which the demonstration of a thickened stomach wall was possible during gastrointestinal examination. This sign has not, to our knowledge, been emphasized in the recent literature. It is a useful indication of the presence of serious abnormality. Case Reports Case I. J. N., a 47-year-old white male, was admitted to Grant Hospital of Chicago with a seven-month history of epigastric pain two hours following meals, relieved somewhat by food. Physical examination and laboratory studies were noncontributory except for absence of free acid in the gastric contents. A gastrointestinal x-ray examination performed elsewhere two weeks prior to admission was said to be normal. Our examination revealed findings reported as those of carcinoma of the stomach (Fig. 2). A gastric resection was performed and the stomach was found to be involved from the pylorus to the cardia. Almost the entire stomach appeared thickened. On section, along the greater curvature in the midportion, the stomach wall measured 1.5 cm. in thickness, compared to 0.5 cm. in the antral portion and 0.4 cm. in the upper fundic portion. The mucosa along the greater curvature showed a pattern of increased thickness and induration of rugae. This hypertrophic change extended toward the so-called magenstrasse in a radius of 4.5 to 5 cm., irregularly, i.e., anteriorly and posteriorly. Microscopic study confirmed the presence of neoplasm. Diagnosis: Undifferentiated infiltrating carcinoma of the stomach. Case II: A. B., a 46-year-old white male, was admitted to the Research and Educational Hospitals, University of Illinois, with a six-week history of epigastric pain. Physical examination and laboratory studies were noncontributory except for the presence of occult blood in the stool and the absence of free hydrochloric acid in the gastric contents. Radiologic study of the upper gastrointestinal tract revealed findings indicative of carcinoma (Fig. 3). A total gastrectomy was performed. At surgery, the entire stomach wall was found to be thickened and indurated—linitis plastica. The disease had spread into the gastrohepatic omentum, but had not metastasized elsewhere. According to the pathologist's report, the gastric mucosa showed giant fixed folds from the esophagus to a point 6.0 cm. from the pylorus. The wall of the stomach appeared thickened by a white submucosal layer, extending almost to the esophagus. There was no ulceration. Microscopic examination revealed an intense overgrowth of connective tissue, with the presence also of carcinoma cells. Diagnosis: Carcinoma of the stomach (linitis plastica)." @default.
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• W2046391159 date "1958-03-01" @default.
• W2046391159 modified "2023-09-25" @default.
• W2046391159 title "Infiltrating Carcinoma of the Stomach: Roentgen Demonstration of the Thickened Stomach Wall" @default.
• W2046391159 doi "https://doi.org/10.1148/70.3.404" @default.
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