Diffuse nodular thickening of the gastric folds After re-making the diagnosis of both endoscopies, as confirmed by the biopsies seen by three pathologists, the patient was referred to another social security hospital where a total esophago-gastrectomy was performed. Linitis plastica may shows very little mucosal lesions on gross appearance. As a rule, since macroscopic features do not often permit the distinction between benign and malignant lesions, multiple endoscopic biopsies are required. However, standard endoscopic biopsy specimens which usually contain only mucosa offer frequently negative results for malignancy. In order to increase the diagnostic yield, the use of a diathermic snare which permits theb obtaining of larger and deeper histologic samples is advised. This technique has a substantial risk of complications, particularly hemorrhage and perforation. Another possibility is to take multiple forceps biopsies from the same site (endoscopic “forage”)
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