LOCALIZED HYPERPLASTIC GASTROPATHY OF THE MUCOUS CELL-TYPE AND MIXED CELL-TYPE (LOCALIZED MENETRIERS-DISEASE) - A REPORT OF 11 PATIENTS

Clinical and pathologic findings in five women and six men with the ra re localized form of hyperplastic gastropathy of the mucous cell-(fove olar) or mixed cell-(mucous cell and glandular) type are reported. Upp er abdominal discomfort, loss of appetite, loss of weight, and anemia were the principal symptoms. Preoperative hypoproteinemia was document ed in two patients. Gross findings consisted of a circumscribed area o f giant folds, well demarcated from the surrounding normal-appearing m ucosa, located predominantly in the corpus in six patients and predomi nantly in the antrum in four patients, Histologically they corresponde d to an increase in the epithelial cell mass principally of mucous cel ls with elongated and sometimes cystically dilated foveolae, accompani ed by a mild Inflammatory infiltrate. This so-called localized form of hyperplastic gastropathy has been known since the first description o f the disease but has gained relatively little attention in the litera ture, However. its recognition seems diagnostically important and path ogenetically interesting. Etiology, pathogenesis, and the natural hist ory are mostly unknown. Five of the 11 patients had concomitant adenoc arcinoma of the stomach. In four of them the carcinoma was not located within but outside the area of hyperplasia. Because of that and becau se of a rather unusual accumulation of other tumors of the gastrointes tinal tract in these patients, it is suggested that localized hyperpla stic gastropathy could be an indicator of an increased risk for gastro intestinal tumors in general more than a possibly premalignant lesion by itself.