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  • Surgical Pathology Criteria

    Menetrier Disease


    • Massive gastric foveolar hyperplasia involving the full thickness of the mucosa

    Diagnostic Criteria

    • Foveolar hyperplasia of gastric body
      • Foveolae corkscrew shaped and may be cystically dilated
        • May extend into submucosa
      • Produces giant gastric folds
    • Atrophy of oxyntic glands
      • Decreased acid secretion
    • Mucous cells extend to the base of the glands
    • Variable edema
    • Mixed inflammatory infiltrate, usually mild
    • Hypertrophic muscularis mucosae may extend into lamina propria
    • Intestinal metaplasia may occur late in disease
    • Granulomas may occur late in disease
    • Antrum spared in adults, involved in children
    • Pediatric cases associated with Cytomegalovirus
      • Present in blood, urine, stomach


    • Decreased acid production
    • Hypoproteinemia, hypoabuminemia, peripheral edema
    • GI bleeding
    • Adults – chronic, insidious onset
    • Children – sudden onset
      • Often self-limited

    Robert V Rouse MD
    Department of Pathology
    Stanford University School of Medicine
    Stanford CA 94305-5342

    Original posting : September 9, 2009

    Differential Diagnosis

      Superficial biopsies showing foveolar hyperplasia may appear identical to:
      • Reflux gastropathy
      • Localized hyperplasia adjacent to other lesions
      • Hyperplastic polyps
      • Cronkhite-Canada polyps
      • Full thickness specimens and clinical and endoscopic correlation are required to demonstrate the extent of foveolar hyperplasia and atrophy of oxyntic glands or the presence of a discrete polyp

      Cronkhite-Canada Syndrome, Gastric Involvement Menetrier Disease
      Hair, nail, skin pigmentation changes present No associated extra-GI lesions
      Colorectal polyps very common Not associated with colorectal polyps
      On biopsy, the polyps and polypoid mucosa in some cases are indistinguishable and both are associated with protein losing enteropathy

      Classification / Lists

      Gastritis / Gastropathy


      • Noffsinger A, Fenoglio-Preiser CM, Maru D, Gilinisky N.  Gastrointestinal Diseases, AFIP Atlas of Nontumor Pathology, First Series, Fascicle 5, 2007.
      • Eisenstat DD, Griffiths AM, Cutz E, Petric M, Drumm B. Acute cytomegalovirus infection in a child with Ménétrier's disease Gastroenterology. 1995 Aug;109(2):592-5.
      • Srivastava A, Lauwers GY. Pathology of non-infective gastritis.Histopathology. 2007 Jan;50(1):15-29.
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