Secondary linitis plastica of the rectum: EUS features and tissue diagnosis (with video) - 23/08/11
Reprint requests: Michael J. Levy, MD, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First St SW, Charlton 8, Rochester, MN 55905.Rochester, Minnesota, USA
Abstract |
Background |
Luminal metastases to the GI tract may be seen at the time of the primary diagnosis or may represent evidence of a distant recurrence.
Objectives |
To determine the prevalence of rectal-wall metastases in patients undergoing an EUS and to describe the EUS features and yield of EUS-guided FNA (EUS-FNA) and Trucut biopsy (TCB).
Design |
A case series.
Setting |
A single tertiary-referral center.
Patients |
Patients undergoing lower GI (LGI) EUS from July 1, 2005, to October 31, 2007.
Intervention |
EUS-FNA and/or TCB.
Main Outcome Measurements |
EUS features and cytologic and/or histologic confirmation of secondary rectal linitis plastica.
Results |
Over the 28-month period, an LGI-EUS was performed in 598 patients with presumed primary rectal cancer, of whom 6 (1%) were diagnosed with rectal-wall metastases. The EUS features were that of diffuse, circumferential, hypoechoic wall-thickening that mimics that of linitis plastica, breaching the muscularis propria in all cases. EUS-FNA and/or TCB of the rectal wall or perirectal lymph node established a diagnosis in all cases. The primary cancers originated from the bladder (n = 3), breast (n = 1), stomach (n = 1), and a right forearm cutaneous melanoma (n = 1). The time interval from the initial primary cancer diagnosis to that of GI-tract rectal metastasis ranged from 0 days (simultaneous diagnoses) to 119 months (mean ± SD 49 ± 43 months).
Limitations |
Although firm EUS criteria of rectal-wall metastases cannot be established based on 6 patients alone, certain features may prove useful for the diagnosis in the clinical practice.
Conclusions |
EUS-FNA and/or TCB can confirm the diagnosis of secondary linitis plastica of the rectum.
El texto completo de este artículo está disponible en PDF.Abbreviations : EUS-FNA, EUS-TCB, LGI-EUS, MRI
Esquema
Vol 68 - N° 3
P. 591-596 - septembre 2008 Regresar al número
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