Scirrhous Gastric Carcinoma - Endoscopy (1 of 15)

An 80 year-old female with satiety and weight loss. The image and the video clip shows diffuse infiltrating adenocarcinoma with signet-ring cells. Gastric linitis plastica is a very particular malignant gastric tumor different from the usual gastric adenocarcinoma. Linitis plastica refers to the diffuse proliferation of the connective tissue, resulting in tissue thickening so that the stomach is constricted and rigid. Pathological exams reported a strong connective stroma-reaction associated with a malignant glandular proliferation of independent cells (signet-ring cells), invading all the layers of the digestive tract, the mucosa being usually save not affected. In spite of well-defined diagnostic criteria in endoscopy and radiology, gastric linitis plastica often presents a diagnostic problem. Due to a unique pattern of infiltration, histological proof of cancer is difficult to achieve and depends upon immunohistological staining.