NON-HODGKIN-LYMPHOMA OF THE STOMACH - A CAUSE OF LINITIS PLASTICA

PURPOSE: To demonstrate the radiologic appearance of linitis plastica in non-Hodgkin lymphoma of the stomach and to correlate radiologic and pathologic findings. MATERIALS AND METHODS: Of 34 cases of non-Hodgki n lymphoma of the stomach in the radiologic archives of the Armed Forc es Institute of Pathology, nine had a linitis plastica appearance at b arium study. The radiologic, endoscopic, and pathologic findings of th ese cases were reviewed. RESULTS: All nine patients (six with primary gastric lymphoma, three with generalized lymphoma with stomach involve ment) were symptomatic. Images from barium studies revealed a linitis plastica appearance with narrowing of the gastric antrum and/or body ( n = 5), narrowing of the body and/or fundus (n = 3), and diffuse gastr ic narrowing (n = 1). On CT scans (n = 7), marked circumferential soft -tissue thickening (average thickness, 2.9 cm) of the gastric wall was seen. Patients were treated with subtotal gastrectomy and gastrojejun ostomy (n = 5) or total gastrectomy and esophagojejunostomy (n = 4). I n all cases, histopathologic specimens revealed a thickened gastric wa ll with lymphomatous cell infiltration. Wall thickening was associated with areas of fibrosis in only one case. CONCLUSION: Non-Hodgkin gast ric lymphoma should be recognized as another cause of linitis plastica , especially in patients with a history of lymphoma or evidence of gen eralized lymphoma at presentation.