ObjectiveTo investigate the clinical, radiological and pathological features of pulmonary lymphangitic carcinomatosis (PLC) from gastric signet ring cell carcinoma.MethodsThe data of 3 cases of PLC from gastric signet ring cell carcinoma were analyzed and relevant literature was reviewed. The electronic databases of Wanfang, VIP, CNKI and PubMed were searched by using the keywords " pulmonary lymphangitic carcinomatosis” and " gastric signet ring cell carcinoma”.ResultsThe average age of three patients was 34 years (ranging from 20 to 50 years). There were 2 males and 1 female. The three patients presented with non-specific respiratory complaints of cough and shortness of breath. Thickening of interlobular septa was the major radiographical abnormality. Mediastinal lymphadenopathy was seen in 1 patient. Bilateral pleural effusion was seen in 2 patients. However, gastroscopy revealed metastatic gastric signet ring cell carcinoma with the presence of lymphagitic carcinomatosis. One patient survived more than seven months with systemic chemotherapy began on day 7 of hospitalization based on the follow-up information available. Literature review found 2 cases of PLC from gastric signet ring cell carcinoma. Two cases were female aged 45 and 59 years. The chief complaints were dry cough and shortness of breath. The survival time was less than 1 month from diagnosis.ConclusionsPLC from gastric signet ring cell carcinoma is easily misdiagnosed as primary pulmonary diseases. Early identification, diagnosis and treatment are crucial to improve the survival of PLC patients.
Objective To summarize the pathological, clinical features and research progress of CT diagnosis of signet ring cell carcinoma of the stomach, in order to help further understanding and early clinical diagnosis and treatment of this disease. Method The literatures related to pathological classification, clinical manifestations, metastasis patterns, prognosis and CT features of gastric signet ring cell carcinoma were searched and reviewed. Results Gastric signet ring cell carcinoma often had no special clinical symptoms and signs in the early stage, and often entered the advanced stage when symptoms such as gastric ulcer appeared. Gastric signet ring cell carcinoma is more prone to peritoneal and ascites metastases than other types of gastric cancer. The more specific metastases include diffuse infiltration along the bile duct and portal vein to the hepatic hilar area and extension to the Glisson sheath. Compared with other types of gastric cancer, there is no prognostic advantage. even worse. CT showed that the lesions were mostly located in the middle and lower 1/3 of the stomach, with a diffuse infiltrating gross appearance, obvious thickening and enhancement of the gastric wall, and delayed enhancement, especially in the low-enhanced area. The emerging dual-energy/spectral CT has shown good application prospects for the diagnosis of gastric cancer. Conclusions The pathological clinical features and CT diagnosis of gastric signet ring cell carcinoma have certain characteristics, but there are still many controversies, which are related to the fact that some pathological characteristics or infiltration patterns of gastric signet ring cell carcinoma itself have not been clearly studied, which will be discussed in the future direction of continuing research.