Stomach
Hypertrophic gastropathy
Menetrier disease


Topic Completed: 1 August 2012

Minor changes: 21 March 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Menetrier's disease

Elliot Weisenberg, M.D.
Page views in 2019: 3,724
Page views in 2020 to date: 2,230
Cite this page: Weisenberg E. Menetrier disease. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/stomachmenetriers.html. Accessed August 13th, 2020.
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
Gross description
  • Usually affects greater curvature of stomach
  • Markedly hypertrophic gastric folds resembling cerebral convolutions
  • Abrupt transition to normal mucosa
Gross images

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Menetrier disease

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
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