STOMACH - Menetrier's disease

This is a partial gastrectomy specimen comprising the distal body and gastric antrum. The mucosal surface of the antrum appears mildly atrophic. The mucosal surface over the greater of the body of the stomach shows numerous papillary projections extending above the normal rugose pattern. These projections appear to consist of infoldings of mucosa, which in areas are necrotic and haemorrhagic. Examination of the cut edge of the specimen showed the gastric thickening to be the result of proliferation within the mucosa. The muscularis externa appears normal. Histologic examination of the specimen showed hyperplasia of the glands with cystic dilatation of the lower portion. The adjacent lamina propria contained strands of fibrous tissue and smooth muscle. The features are those of Menetrier's disease or giant hypertrophy of the stomach.
This 21-year-old male was admitted in 1985 with non-A, non-B hepatitis. He was shown to have Menetrier's disease which was complicated by massive haemorrhage. This led to subtotal gastrectomy with a Bilroth II recontruction. On the basis of ischaemia he developed acute renal tubular necrosis and required dialysis. His renal function gradually improved and dialysis was discontinued. He has since remained well.