All are true regarding Menetrier’s disease, EXCEPT:
Question Category:
Correct Answer:
Exophytic growth
Description:
Answer is B (Exophytic growth) Menetrier's disease is characterized hr hyperophy of gastric mucosa and not hr exoph;'tic growth. Menetrier's disease Menetrier's disease is a relatively rare disorder of the stomach characterized by lar e touous mucosal folds Etiology * Etiology is unknown * Over expression of growth factors such as TGF are suggested Pathology Gross * Marked Hyperophy of gastric folds/Rugaee * Hyperophy results from hyperplasia of mucus producing cells (mucosa)Q * Hyperophy is most prominent in the body and fundus deg Histological/microscopic * Massive foveolar hyperplasia (Hyperplasia of surface and glandular mucosal cells). * Pits of gastric glands elongate and may become touous * Lamina propria may contain a mild chronic inflammatory infiltrate (Note: Although lamina propria may contain an inflammatory infiltrates, Menetrier's disease is not considered a form of gastritis Clinical picture * Protein losing enteropathy is characteristic Excessive protein is lost from the thickened mucosa into the gut which results in hypoprotenemia and edema * Gastric acid secretion is usually reduced or absent This happens because mucosal cell hyperplasia replaces most of the parietal cells. * Epigastric pain accompanied by nausea, vomiting anorexia and weight loss Ove bleeding is unusual but occult gastrointestinal bleeding may occur Differential Diagnosis DD includes conditions that may present with large gastric folds: ZES Malignancy Infiltrative disorders eg sarcoidosis Infectious etiology (CMV, Histoplasmosis, syphilis) Prognosis These is an increased risk of adenocarcinoma of stomach in adults with menetrier's disease (CSDT)
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