title: Menetrier's disease: a form of hypertrophic gastropathy or gastritis?
abstract: BACKGROUND
  Menetrier's disease is characterized by giant gastric folds and foveolar hyperplasia. The extent of mucosal inflammation and glandular atrophy, however, is controversial. The aim of this study was to test the hypothesis that patients previously diagnosed with Menetrier's disease actually represent at least two diseases: (1) Hypertrophic lymphocytic gastritis (HLG) and (2) Massive foveolar hyperplasia and minimal inflammation (MFH).
  
  
  METHODS
  All cases of possible Menetrier's disease were identified, and their clinical, laboratory, and pathological data were reviewed. In twenty-three patients with giant fundal folds, full-thickness tissue specimens (n = 19) or large suction biopsy (n = 4) tissue specimens were obtained.
  
  
  RESULTS
  Two distinct, nonoverlapping histological patterns were found; 13 patients had HLG and 10 patients had MFH. Clinical features and frequency of Helicobacter pylori were similar in these two groups. Patients with HLG had severe inflammation with numerous intraepithelial lymphocytes and mild foveolar hyperplasia. Alternatively, patients with MFH had greater foveolar hyperplasia, significantly thicker mucosa, and greater mucosal edema.
  
  
  CONCLUSIONS
  Patients with MFH represent a form of hypertrophic gastropathy and should be designated as having Menetrier's disease, whereas patients with HLG should be considered part of the spectrum of lymphocytic gastritis.
authors: Division of Gastroenterology and Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors: H C
authors: HC
authors: Wolfsen
authors: H A
authors: HA
authors: Carpenter
authors: N J
authors: NJ
authors: Talley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005756:Gastritis / Q000382:microbiology / Q000473:pathology*; D005758:Gastritis, Hypertrophic / Q000382:microbiology / Q000473:pathology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000473:pathology; D013270:Stomach / Q000382:microbiology / Q000473:pathology*