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'''Ménétrier's disease''' is a very rare pathology of the [[stomach]]. It is also known as '''diffuse foveolar cell hyperplasia''' | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Ménétrier's disease -- very low mag.jpg | |||
| Width = | |||
| Caption = Biopsy compatible with Ménétrier's disease. [[H&E stain]]. | |||
| Synonyms = diffuse foveolar cell hyperplasia, hypertrophic protein-losing gastropathy, | |||
| Micro = marked foveolar cell hyperplasia, decreased parietal cells, +/-inflammation | |||
| Subtypes = | |||
| LMDDx = [[Cronkhite-Canada syndrome]], [[hyperplastic polyp of the stomach]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = "bag of worms" appearance - very thick gastric folds | |||
| Grossing = | |||
| Site = [[stomach]] | |||
| Assdx = [[gastric adenocarcinoma]] | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = emesis (intractible), peripheral edema | |||
| Symptoms = abdominal pain | |||
| Prevalence = extremely rare | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = very thick gastric folds | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = [[gastric cancer]] | |||
}} | |||
'''Ménétrier's disease''' is a very rare pathology of the [[stomach]]. It is also known as '''diffuse foveolar cell hyperplasia''',<ref name=Ref_PCPBoD8_410>{{Ref PCPBoD8|410}}</ref> and '''hypertrophic protein-losing gastropathy'''.<ref name=pmid24092036>{{Cite journal | last1 = Hillman | first1 = MM. | last2 = Meinarde | first2 = LL. | last3 = Furnes | first3 = RA. | last4 = Daruich | first4 = ML. | last5 = Riva | first5 = V. | last6 = Cuestas | first6 = E. | title = [Protein losing gastroenteropathy and possible relationship to cytomegalovirus infection: Ménétrier disease in a child]. | journal = Arch Argent Pediatr | volume = 111 | issue = 5 | pages = 446-9 | month = Oct | year = 2013 | doi = 10.1590/S0325-00752013000500016 | PMID = 24092036 }}</ref><ref name=pmid1298040>{{Cite journal | last1 = Meuwissen | first1 = SG. | last2 = Ridwan | first2 = BU. | last3 = Hasper | first3 = HJ. | last4 = Innemee | first4 = G. | title = Hypertrophic protein-losing gastropathy. A retrospective analysis of 40 cases in The Netherlands. The Dutch Ménétrier Study Group. | journal = Scand J Gastroenterol Suppl | volume = 194 | issue = | pages = 1-7 | month = | year = 1992 | doi = | PMID = 1298040 }}</ref> | |||
==General== | ==General== | ||
*Super rare. | *Super rare. | ||
*Increased risk of gastric adenocarcinoma.<ref name=Ref_PCPBoD8_410>{{Ref PCPBoD8|410}}</ref> | *Increased risk of [[gastric adenocarcinoma]].<ref name=Ref_PCPBoD8_410>{{Ref PCPBoD8|410}}</ref> | ||
Clinical:<ref name=pmid20926644>{{Cite journal | last1 = Rich | first1 = A. | last2 = Toro | first2 = TZ. | last3 = Tanksley | first3 = J. | last4 = Fiske | first4 = WH. | last5 = Lind | first5 = CD. | last6 = Ayers | first6 = GD. | last7 = Piessevaux | first7 = H. | last8 = Washington | first8 = MK. | last9 = Coffey | first9 = RJ. | title = Distinguishing Ménétrier's disease from its mimics. | journal = Gut | volume = 59 | issue = 12 | pages = 1617-24 | month = Dec | year = 2010 | doi = 10.1136/gut.2010.220061 | PMID = 20926644 }}</ref> | Clinical:<ref name=pmid20926644>{{Cite journal | last1 = Rich | first1 = A. | last2 = Toro | first2 = TZ. | last3 = Tanksley | first3 = J. | last4 = Fiske | first4 = WH. | last5 = Lind | first5 = CD. | last6 = Ayers | first6 = GD. | last7 = Piessevaux | first7 = H. | last8 = Washington | first8 = MK. | last9 = Coffey | first9 = RJ. | title = Distinguishing Ménétrier's disease from its mimics. | journal = Gut | volume = 59 | issue = 12 | pages = 1617-24 | month = Dec | year = 2010 | doi = 10.1136/gut.2010.220061 | PMID = 20926644 }}</ref> | ||
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Epidemiology: | Epidemiology: | ||
*Men > women. | *Men > women. | ||
*Adults usually 50s. | *Adults usually 50s.‡ | ||
*Associated with [[ulcerative colitis]]. | *Associated with [[ulcerative colitis]]. | ||
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*EGFR inhibitors.<ref name=pmid18321437>{{Cite journal | last1 = Toubia | first1 = N. | last2 = Schubert | first2 = ML. | title = Menetrier's Disease. | journal = Curr Treat Options Gastroenterol | volume = 11 | issue = 2 | pages = 103-8 | month = Apr | year = 2008 | doi = | PMID = 18321437 }}</ref> | *EGFR inhibitors.<ref name=pmid18321437>{{Cite journal | last1 = Toubia | first1 = N. | last2 = Schubert | first2 = ML. | title = Menetrier's Disease. | journal = Curr Treat Options Gastroenterol | volume = 11 | issue = 2 | pages = 103-8 | month = Apr | year = 2008 | doi = | PMID = 18321437 }}</ref> | ||
*Gastrectomy. | *Gastrectomy. | ||
Note: | |||
*‡ A similar constellation of symptoms can be seen in children and may be associated with [[CMV]] infection.<ref name=pmid1298040/><ref>{{Cite journal | last1 = Kindermann | first1 = A. | last2 = Koletzko | first2 = S. | title = [Protein-losing giant fold gastritis in childhood--a case report and differentiation from Ménétrier disease of adulthood]. | journal = Z Gastroenterol | volume = 36 | issue = 2 | pages = 165-71 | month = Feb | year = 1998 | doi = | PMID = 9544500 }}</ref> | |||
==Gross== | ==Gross== | ||
*"Bag of worms" appearance - very thick gastric folds. | *"Bag of worms" appearance - very thick gastric folds. | ||
===Images=== | |||
<gallery> | |||
Image:Menetrier.jpg | Ménétrier's disease. (WC/AFIP) | |||
</gallery> | |||
==Microscopic== | ==Microscopic== | ||
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*[[Hyperplastic polyp of the stomach]]. | *[[Hyperplastic polyp of the stomach]]. | ||
Images: | ===Images=== | ||
*[http://path.upmc.edu/cases/case36.html Ménétrier's disease - | <gallery> | ||
Image: Ménétrier's disease -- very low mag.jpg | MD - very low mag. (WC) | |||
Image: Ménétrier's disease -- low mag.jpg | MD - low mag. (WC) | |||
Image: Ménétrier's disease - alt -- low mag.jpg | MD - low mag. (WC) | |||
Image: Ménétrier's disease -- intermed mag.jpg | MD - intermed. mag. (WC) | |||
Image: Ménétrier's disease -- high mag.jpg | MD - high mag. (WC) | |||
</gallery> | |||
www: | |||
*[http://path.upmc.edu/cases/case36.html Ménétrier's disease - low quality images (upmc.edu)]. | |||
*[http://radiographics.rsna.org/content/29/1/297.full.pdf Ménétrier's disease - several images from the AFIP (rsna.org)].<ref name=pmid19168850>{{Cite journal | last1 = Friedman | first1 = J. | last2 = Platnick | first2 = J. | last3 = Farruggia | first3 = S. | last4 = Khilko | first4 = N. | last5 = Mody | first5 = K. | last6 = Tyshkov | first6 = M. | title = Ménétrier disease. | journal = Radiographics | volume = 29 | issue = 1 | pages = 297-301 | month = | year = | doi = 10.1148/rg.291075216 | PMID = 19168850 | URL = http://radiographics.rsnajnls.org/cgi/pmidlookup?view=long&pmid=19168850 }}</ref> | |||
==See also== | ==See also== |
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