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The Korean Journal of Pathology 1998;32(2): 142-146.
Menetrier's Disease Report of two cases.
Joo Heon Kim, Dong Geun Lee, Sang Woo Juhng
1Department of Pathology, Medical school, Chonbuk University, Chon-Joo, Korea.
2Department of Pathology, Medical School, Chonnam University, Kwangju, Korea.
ABSTRACT
Menetrier's disease is characterized by enlarged gastric folds with foveolar hyperplasia and cystic dilatation of gastric glands. The additional biochemical features of hypoproteinemia, hypochlorhydria, and increased gastric mucus are often encountered. The pathogenesis and etiologic factors have not been clearly defined. In this report, we present two cases of Menetrier's disease in the stomach, one occurring in a 38-year-old male, associated with massive hematemesis, and the other in a 39-year-old male. Grossly, both cases showed marked giant gastric rugal folds resembling cerebral convolutions, sparing the antral portion. Microscopically, the giant gastric rugal folds consisted of the striking foveolar hyperplasia accompanied by an occasional presence of the smooth muscle fibers from the muscularis mucosa. The immunohistochemical stain revealed an intense positive reaction for transforming growth factor-alpha (TGF-alpha) and epidermal growth factor receptor (EGF-R) in the majority of mucous cells throughout the gastric mucosa and parietal cells, but did not reveal for epidermal growth factor (EGF). We suggested that TGF-alpha and EGF-R might be involved in the pathogenesis of Menetrier's disese.
Key Words: Menetrier's disease; Hematemesis; Immunohistochemistry; Pathogenesis
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