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直肠炎病例系列:一种罕见病症。

Rectal linitis case series: An infrequent entity.

作者信息

Del Val-Ruíz Pablo, Fernández-Martínez Daniel, Carrasco-Aguilera Beatriz, Rubiera-Valdés Miriam, Diaz-Vico Tamara, García-Flórez Luis Joaquín

机构信息

Unit of Coloproctology, Department of General and Digestive Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain.

Unit of Coloproctology, Department of General and Digestive Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain; Institute for Health Research of the Principado de Asturias (ISPA), Oviedo, Spain.

出版信息

Int J Surg Case Rep. 2025 Jul;132:111324. doi: 10.1016/j.ijscr.2025.111324. Epub 2025 Apr 21.

DOI:10.1016/j.ijscr.2025.111324
PMID:40409042
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12152639/
Abstract

INTRODUCTION

Linitis Plastica (LP) is a rare condition characterized by diffuse infiltration of the submucosal and muscularis propria layers of a hollow organ by malignant cells.

PRESENTATION OF CASE

Three patients underwent colonoscopy, which revealed rectal stenosis with preserved mucosa. CT and MRI demonstrated circumferential thickening of the rectal wall. Histopathological and immunohistochemical analyses confirmed submucosal infiltration by malignant cells. All three patients received chemotherapy but died due to disease progression.

DISCUSSION

Symptoms of rectal LP are nonspecific. Rectal examination typically reveals a concentric, rigid stricture. Colonoscopy shows circumferential luminal narrowing with intact mucosa. Imaging studies detect circumferential rectal wall thickening primarily affecting the submucosa. A definitive diagnosis requires histological analysis, but endoscopic biopsies are often non-diagnostic. Given the typically late-stage diagnosis and lack of effective treatments, chemotherapy is the mainstay, with surgery reserved for complications. Prognosis remains poor.

CONCLUSION

The diagnosis and management of rectal LP present significant challenges due to its rarity, nonspecific endoscopic findings, and frequently inconclusive biopsies.

摘要

引言

皮革胃是一种罕见疾病,其特征为恶性细胞弥漫浸润中空器官的黏膜下层和固有肌层。

病例介绍

三名患者接受了结肠镜检查,结果显示直肠狭窄但黏膜完整。CT和MRI显示直肠壁环形增厚。组织病理学和免疫组织化学分析证实存在恶性细胞的黏膜下浸润。所有三名患者均接受了化疗,但均因疾病进展而死亡。

讨论

直肠皮革胃的症状不具有特异性。直肠指检通常显示为同心性、硬性狭窄。结肠镜检查显示管腔环形狭窄且黏膜完整。影像学检查可发现主要累及黏膜下层的直肠壁环形增厚。明确诊断需要组织学分析,但内镜活检往往无法确诊。鉴于通常诊断较晚且缺乏有效治疗方法,化疗是主要治疗手段,手术仅用于治疗并发症。预后仍然很差。

结论

由于直肠皮革胃罕见、内镜检查结果不具特异性且活检结果常常无法确诊,其诊断和治疗面临重大挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/0be3088f7379/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/45151d21795b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/a93cc784354e/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/073e0de133d5/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/622c0872dcb4/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/23e9a6509deb/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/0be3088f7379/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/45151d21795b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/a93cc784354e/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/073e0de133d5/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/622c0872dcb4/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/23e9a6509deb/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b8/12152639/0be3088f7379/gr6.jpg

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本文引用的文献

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Rectal linitis plastica as the first presentation of metastatic lobular breast cancer: an endoscopic ultrasound diagnosis.直肠皮革样癌作为转移性乳腺小叶癌的首发表现:内镜超声诊断。
Clin J Gastroenterol. 2022 Dec;15(6):1072-1077. doi: 10.1007/s12328-022-01690-w. Epub 2022 Sep 13.
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Linitis plastica of the rectum secondary to metastatic prostate cancer: A case report of a rare presentation and literature review.转移性前列腺癌继发直肠皮革胃:罕见病例报告及文献复习
Urol Ann. 2021 Oct-Dec;13(4):442-445. doi: 10.4103/UA.UA_188_20. Epub 2021 Sep 2.
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Blocked by a Ring: A Case of Gastric Linitis Plastica Presenting as Large Bowel Obstruction Secondary to Rectal Stenosis.被环阻塞:一例表现为直肠狭窄继发大肠梗阻的皮革胃病例
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