Diffuse-type gastric cancer (DGC), also known as “scirrhous carcinoma” or “linitis plastica,” is a special type of gastric cancer characterized by diffusely infiltrating lesions forming abundant fibrous stroma, and poor distensibility of the stomach depending on the extent of the lesion. Since DGC is found to be at a far-advanced stage at the time of diagnosis, it is often treated with systemic chemotherapy. DGC has the poorest prognosis among all types of gastric cancers, with a 5-year survival rate of approx. 3% to 10% [1-3]....

Patient population From September 2006 to December 2015, 21 consecutive patients with DGC who were evaluated by CECTG before treatment were enrolled in our study. The definition of DGC was made based on medical records of endoscopy or fluoroscopy, the findings of which were as follows: an infiltrating tumor sparing the superficial mucosal layer with no bulky intraluminal mass or prominent ulcer [8]. The subjects were seven males and 14 females whose median age was 65. All cases were histologically proven poorly differentiated adenocarcinomas. Patients...

In the MPR image analysis, the median long-axis tumor length was 99.5 mm and the median maximum thickness was 13.8 mm. The number of involved regions were more than tow regions in 15 cases and one in six cases. The maximum circumference involvement was full in 16 cases and non-full in the other five cases. In the axial image analysis, all lesions were observed to be double-layered in the arterial phase. In the delayed phase, 18 lesions were single-layered and three were double-layered (Table 2)....

Our findings suggest that DGCs tend to demonstrate homogeneous wall thickening, and that DGCs tend to be double-layered with a moderately enhanced inner layer and a mildly enhanced outer layer in the arterial phase, and to show a moderately enhanced single-layer in the delayed phase. These specific CT enhancement patterns may be helpful in detecting DGCs as well as estimating the tumor localization or extent.

1. Schauer M, Peiper M, Theisen J, Knoefel W. Prognostic factors in patients with diffuse type gastric cancer (linitis plastica) after operative treatment. Eur J Med Res. 2011;16(1):29-33. 2. Salvon-Harman JC, Cady B, Nikulasson S, Khettry U, Stone MD, Lavin P. Shifting proportions of gastric adenocarcinomas. Arch Surg. 1994;129(4):381-8; discussion 8-9. 3. Park JC, Lee YC, Kim JH, Kim YJ, Lee SK, Hyung WJ, et al. Clinicopathological aspects and prognostic value with respect to age: an analysis of 3,362 consecutive gastric cancer patients. J Surg...