You Jin Hee, Song Ji Soo, Jang Kyu Yun, Lee Min Ro
Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Chonbuk, South Korea.
Department of Pathology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Chonbuk, South Korea.
World J Clin Cases. 2018 Oct 26;6(12):554-558. doi: 10.12998/wjcc.v6.i12.554.
Linitis plastica is a rare condition showing circumferentially infiltrating intramural anaplastic carcinoma in a hollow viscus, resulting in a tissue thickening of the involved organ as constricted, inelastic, and rigid. While most secondary rectal linitis plastica (RLP) is caused by metastasis from stomach, breast, gallbladder, or bladder cancer, we report an extremely rare and unique case of secondary RLP due to prostate cancer with computed tomography (CT) and magnetic resonance imaging (MRI) findings, including diffusion weighted imaging (DWI). A 78-year-old man presented with approximately a 2-mo history of constipation and without cancer history. On sigmoidoscopy, there was a luminal narrowing and thickening of rectum with mucosa being grossly normal in its appearance. On contrast-enhanced CT, marked contrast enhancement with wall thickening of rectum was noted. On pelvic MRI, rectal wall thickening showed a target sign on both T2-weighted imaging and DWI. A diffuse infiltrative lesion was suspected in the prostate gland based on low signal intensity on T2-weighted imaging and restricted diffusion. A transanal full-thickness excisional biopsy revealed metastasis from a prostate adenocarcinoma invading the submucosa to the muscularis propria consistent with metastatic RLP. We would like to emphasize the CT and MRI findings of metastatic RLP due to prostate cancer.
皮革胃是一种罕见的疾病,表现为中空脏器壁内间变性癌呈环形浸润,导致受累器官组织增厚,呈狭窄、无弹性和僵硬状态。虽然大多数继发性直肠皮革胃(RLP)是由胃癌、乳腺癌、胆囊癌或膀胱癌转移引起的,但我们报告了一例极其罕见且独特的因前列腺癌导致的继发性RLP病例,并展示了计算机断层扫描(CT)和磁共振成像(MRI)结果,包括扩散加权成像(DWI)。一名78岁男性,有大约2个月的便秘病史,无癌症病史。乙状结肠镜检查显示直肠管腔狭窄和增厚,黏膜外观大致正常。增强CT显示直肠壁增厚并伴有明显的强化。盆腔MRI显示,在T2加权成像和DWI上,直肠壁增厚均表现为靶征。基于T2加权成像上的低信号强度和扩散受限,怀疑前列腺存在弥漫性浸润性病变。经肛门全层切除活检显示前列腺腺癌转移,侵犯黏膜下层至固有肌层,符合转移性RLP。我们想强调因前列腺癌导致的转移性RLP的CT和MRI表现。