Stomach
Hypertrophic gastropathy
Menetrier disease
Author: Elliot Weisenberg, M.D.
Last author update: 1 August 2012
Last staff update: 1 September 2020
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Menetrier's disease
Table of Contents
Definition / general | Clinical features | Treatment | Gross description | Microscopic (histologic) description | Differential diagnosisCite this page: Weisenberg E. Menetrier disease. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stomachmenetriers.html. Accessed April 20th, 2024.
Definition / general
- A hyperplastic gastropathy described by Menetrier in 1888 as polyadenomes en nappe
- Giant mucosal folds involving fundus and body, usually (not always) spares antrum
Clinical features
- 75% men
- Mean age 30 - 50s; chronic and severe
- Children: uncommon; often have CMV or other infection, peripheral eosinophilia
- Peripheral edema present due to mucosal protein loss, variable weight loss, diarrhea
- Low acid production even after stimulation
- Likely due to excessive transforming growth factor alpha with increased signalling of EGFR
- Grossly and radiologically resembles Zollinger-Ellison syndrome
Localized Menetrier disease:
- Rare localized hyperplastic gastropathy, associated with stomach adenocarcinoma (Am J Surg Pathol 1997;21:1334)
- Symptoms: upper abdominal discomfort, loss of appetite, weight loss, anemia, occasionally hypoproteinemia
- Gross description: circumscribed area of giant folds, well demarcated from surrounding normal appearing mucosa, usually in body or antrum
- Micro description: increase in epithelial cell mass of mucous cells with long, sometimes cystically dilated foveola, mild inflammatory infiltrate
Treatment
- Children: self limited
- Adults: may require partial gastrectomy; monoclonal antibody therapy may be helpful (Clin Gastroenterol Hepatol 2005;3:654)
Gross description
- Usually affects greater curvature of stomach
- Markedly hypertrophic gastric folds resembling cerebral convolutions
- Abrupt transition to normal mucosa
Microscopic (histologic) description
- Marked foveolar hyperplasia, tortuous (corkscrew) and cystically dilated foveolar glands
- May extend into muscularis mucosa
- Atrophic glandular compartment
- Edematous and mildly inflamed lamina propria, may have increased intraepithelial lymphocytes
Differential diagnosis
- CMV (Am J Gastroenterol 2001;96:223)
- Lymphoma and carcinoma
- Varioliform gastritis (hypertrophic lymphocytic gastritis); clinicopatholgic correlation is necessary
