Difference between revisions of "Ménétrier's disease"

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*"Bag of worms" appearance - very thick gastric folds.
*"Bag of worms" appearance - very thick gastric folds.


Image:
===Images===
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<gallery>
Image:Menetrier.jpg | Ménétrier's disease. (WC/AFIP)
Image:Menetrier.jpg | Ménétrier's disease. (WC/AFIP)
Image:Riesenfaltengastritis_Endoskopie_003.jpg | Ménétrier's disease - endoscopic image. (WC)
</gallery>
</gallery>



Revision as of 11:36, 29 September 2013

Ménétrier's disease
Diagnosis in short

LM marked foveolar cell hyperplasia, decreased parietal cells, +/-inflammation
LM DDx Cronkhite-Canada syndrome, hyperplastic polyp of the stomach
Gross "bag of worms" appearance - very thick gastric folds
Site stomach

Associated Dx gastric adenocarcinoma
Signs emesis (intractible), peripheral edema
Symptoms abdominal pain
Prevalence extremely rare

Ménétrier's disease is a very rare pathology of the stomach. It is also known as diffuse foveolar cell hyperplasia.[1]

General

Clinical:[2]

  • Classical: nausea, emesis, abdominal pain and peripheral edema.
    • Emesis (intractable) - most important.

Other:

  • Gastric mass (may mimic cancer).
  • Hypochlorhydria.
  • Protein loss (hypoalbuminemia) - leads to peripheral edema.

Epidemiology:

Treatment:

  • EGFR inhibitors.[3]
  • Gastrectomy.

Gross

  • "Bag of worms" appearance - very thick gastric folds.

Images

Microscopic

Features:[1]

  • Foveolar cell hyperplasia - key feature.
  • Decreased parietal cells.
  • +/-Inflammation.

DDx:

Images:

See also

References

  1. 1.0 1.1 1.2 Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 410. ISBN 978-1416054542.
  2. Rich, A.; Toro, TZ.; Tanksley, J.; Fiske, WH.; Lind, CD.; Ayers, GD.; Piessevaux, H.; Washington, MK. et al. (Dec 2010). "Distinguishing Ménétrier's disease from its mimics.". Gut 59 (12): 1617-24. doi:10.1136/gut.2010.220061. PMID 20926644.
  3. Toubia, N.; Schubert, ML. (Apr 2008). "Menetrier's Disease.". Curr Treat Options Gastroenterol 11 (2): 103-8. PMID 18321437.
  4. Junnarkar SP, Sloan JM, Johnston BT, Laird JD, Irwin ST (May 2001). "Cronkhite-Canada syndrome". The Ulster medical journal 70 (1): 56–8. PMC 2449205. PMID 11428328. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2449205/.