Stomach and beyond: imaging the linitis plastica phenotype in signet ring cell carcinoma.

Edward McDermott, Korosh Khalili, Tae Kyoung Kim, Vanessa Murad, Chloe Sew Hee, Khaled Y Elbanna

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In one paragraph

Review in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Edward McDermottJoint Department of Medical Imaging (JDMI), University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, ON, Canada.

Korosh KhaliliJoint Department of Medical Imaging (JDMI), University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, ON, Canada.

Tae Kyoung KimJoint Department of Medical Imaging (JDMI), University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, ON, Canada.

Vanessa MuradJoint Department of Medical Imaging (JDMI), University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, ON, Canada.

Chloe Sew HeeJoint Department of Medical Imaging (JDMI), University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, ON, Canada.

Khaled Y ElbannaJoint Department of Medical Imaging (JDMI), University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, ON, Canada. Khaled.Elbanna@uhn.ca.ORCID http://orcid.org/0000-0001-6499-9261

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The linitis plastica (LP) phenotype is characterized by diffuse infiltrative mural thickening, reduced distensibility, and absent or subtle mucosal abnormality. It creates a diagnostic paradox in which cross-sectional imaging may suggest advanced malignancy while superficial endoscopic biopsies remain nondiagnostic. This review addresses three key radiologic tasks: recognizing the infiltrative, non-polypoid pattern on cross-sectional imaging; distinguishing it from malignant, benign, and technical mimics; and identifying when persistent imaging suspicion should prompt recommendation of EUS-guided deep tissue sampling after nondiagnostic mucosal biopsy. In the stomach, LP most commonly reflects primary gastric signet ring cell carcinoma (SRCC), but metastatic invasive lobular carcinoma (ILC) of the breast is its most important mimic and may present as delayed gastric involvement years after the initial breast cancer diagnosis. These entities share convergent discohesive tumor biology linked to loss of E-cadherin function encoded by CDH1, a relationship also reflected in the combined gastric and lobular breast cancer risk recognized in Hereditary Diffuse Gastric Cancer syndrome. Beyond the stomach, the linitis pattern may occur as primary or metastatic disease in the rectum, colon, esophagus, duodenum, and urinary bladder. Metastatic spread may also involve the biliary tract, ureters, and gallbladder, where mural thickening or stricturing can mimic inflammatory disease or an alternative primary neoplasm. Recognition of this metastatic hollow-viscus pattern, particularly in patients with known or remote ILC or SRCC, may reduce diagnostic delay and prompt appropriate tissue sampling and pathologic work-up.

Indexed as

Computed tomographyEndoscopic ultrasonographyGastric wall thickeningLinitis plasticaMagnetic resonance imagingStomach neoplasms

Identifiers

PMID42360344

DOI10.14309/crj.2018.51

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.