Hypertrophic gastropathy

Menetrier disease

Last author update: 1 August 2012
Last staff update: 1 September 2020

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PubMed Search: Menetrier's disease

Elliot Weisenberg, M.D.
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Cite this page: Weisenberg E. Menetrier disease. website. Accessed September 26th, 2023.
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
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
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