Does Linitis Plastica Affect Only the Gastric Body?
No, linitis plastica does not exclusively affect the gastric body—it is a diffuse variant of gastric cancer that may affect most or all of the stomach, commonly presenting as widespread infiltration of the gastric wall. 1
Anatomical Distribution Pattern
Linitis plastica characteristically involves extensive areas of the stomach, not just the gastric body, and is described as a diffuse variant that "may affect most of the stomach" with the classic "leather bottle stomach" appearance. 1
The disease typically presents in the fundic gland area but spreads diffusely throughout the gastric wall, causing thickening and rigidity that can involve multiple anatomic regions. 2
Primary lesions can originate in various locations (such as the gastric antrum) and then spread to involve the upper gastric body and other regions through submucosal and transmural infiltration. 2
Clinical Recognition of Extent
Morphological changes in gastric folds across multiple regions indicate tumor spread, with characteristic findings including abnormal folds that cross to form a "waffle-like appearance" in areas beyond the primary lesion. 2
The diagnosis should include assessment of both the primary lesion and evaluation of morphological changes throughout the stomach, as the tumor commonly spreads from its origin to involve distant gastric regions. 2
Endoscopic findings typically show mucosal swelling and poor distensibility that can affect the antrum, body, and fundus, with reduced gastric distension and deformation of the entire stomach creating the characteristic leather bottle appearance. 2, 3
Pathological Characteristics
Linitis plastica is classified as a diffuse histotype according to Lauren classification, characterized by infiltration of the gastric wall by atypical cells with diffuse growth patterns, cords, microglands, and small mucin lakes throughout affected areas. 1
Advanced hereditary diffuse gastric cancer (HDGC) predominantly presents as linitis plastica with infiltration throughout the gastric wall, demonstrating that this pattern represents widespread rather than localized disease. 1
Diagnostic Pitfall to Avoid
- Do not assume linitis plastica is confined to one anatomic region based on the location of visible endoscopic abnormalities, as the diffuse infiltrative nature means microscopic disease extends far beyond what is visible, requiring total gastrectomy rather than partial resection for curative intent. 1