J Pathol Transl Med.  2016 Jan;50(1):10-16. 10.4132/jptm.2015.09.15.

Menetrier's Disease: Its Mimickers and Pathogenesis

• Huh WJ
• Coffey RJ
• Washington MK

• KMID: 2211396
• DOI: http://doi.org/10.4132/jptm.2015.09.15

Abstract

Menetrier's disease is a rare protein-losing hypertrophic gastropathy. Histologically, it can be mistaken for other disorders showing hypertrophic gastropathy. The pathogenesis of Menetrier's disease is not fully understood; however, it appears that the epidermal growth factor receptor (EGFR) ligand, transforming growth factor alpha, contributes to the pathogenesis of this disorder. In this review, we will discuss disease entities that can mimic Menetrier's disease and the role of EGFR signaling in Menetrier's disease.

Keyword

Menetrier's disease; Gastric polyp; Transforming growth factor alpha

MeSH Terms

Gastritis, Hypertrophic*
Receptor, Epidermal Growth Factor
Transforming Growth Factor alpha
Receptor, Epidermal Growth Factor
Transforming Growth Factor alpha

Figure

• 

  Fig. 1. Endoscopic appearance of Ménétrier’s disease and juvenile polyposis syndrome. (A) Gastric body of Ménétrier’s disease patient with diffuse hypertrophic gastric folds. (B) Gastric antrum of the same patient is not involved. (C) Gastric body of juvenile polyposis syndrome patient with multiple sessile polyps. (D) Juvenile polyps in the duodenum.

• 

  Fig. 2. Histologic comparison of Ménétrier’s disease and gastric polyps. (A) Ménétrier’s disease shows foveolar hyperplasia with corkscrew morphology and cystically dilated deep glands; however, overall linear architecture is maintained. (B) Juvenile polyp shows foveolar hyperplasia with cystically dilated superficial and deep glands. Linear architecture is disrupted. (C) Peutz-Jeghers polyp shows foveolar hyperplasia and cystically dilated glands. Lamina propria of Ménétrier’s disease shows strands of smooth muscle bundles (D) whereas lamina propria of juvenile polyp is edematous without prominent smooth muscle (E). (F) Peutz-Jeghers polyp shows arborizing smooth muscle strands in the lamina propria, which is less prominent than counterparts in small intestine or colon.

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  Fig. 3. Immunohistochemistry of phosphorylated EGFR (pEGFR). Hyperplastic foveolar epithelium of both Ménétrier’s disease (A) and juvenile polyp (B) shows membranous pEGFR staining.

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