Computed tomography features of gastrointestinal linitis plastica: spectrum of findings in early and delayed phase imaging

Purpose

To analyze the features of gastrointestinal linitis plastica obtained by computed tomography (CT).

Materials and methods

We conducted a single-center, retrospective analysis of 45 cases of gastrointestinal tract linitis plastica collected over a 10-year period. “Linitis plastica” was defined based on histological characteristics. Primary and secondary linitis plastica were included. Two readers independently assessed the radiological findings (i.e., number of lesions, mass, wall thickening, and enhancement).

Results

The patient cohort comprised 23 men and 22 women with an average age of 63.2 years. The main presenting signs and symptoms were impaired general health and ascites (22/45 patients, 48.8%). The stomach was the affected organ in 68.3% of the cases, while the rectum was affected in 11.7% of the cases. Primary linitis was found in 73.3% of the cases, and solitary lesions were found in 77.8% of the cases. The most common CT finding was wall thickening (91.7%) with a complete disappearance of folds and enhancement of the entire wall at 2 min. Four lesions (6.6%) were described as masses, and only one (1.7%) was described as a wall atrophy.

Conclusion

Linitis plastica can affect the entire digestive system. Its potentially secondary nature necessitates a systematic search for a primary tumor. An appropriate CT protocol is required to detect the specific radiological features of this fibrous cancer. CT can help confirm the diagnosis of linitis plastica, rule out differential diagnoses, and indicate the need for deep biopsies where possible.