A 58-year-old man presents with epigastric pain, early satiety, peripheral oedema, and hypoalbuminaemia with normal liver function. EGD shows giant, thickened, cerebriform rugal folds confined to the fundus and body, and biopsy shows foveolar hyperplasia with glandular atrophy. Which pair correctly matches this disorder with its key pathophysiologic feature?

• A Zollinger-Ellison syndrome with gastrin-driven parietal cell hyperplasia
• B Autoimmune metaplastic atrophic gastritis with anti-parietal cell mediated oxyntic destruction
• C Menetrier disease with TGF-alpha driven foveolar hyperplasia and protein loss ✓
• D Linitis plastica with diffuse signet ring cell infiltration of the gastric wall

Explanation

Menetrier disease is a rare hypertrophic gastropathy of the fundus and body characterised by massive foveolar (mucous cell) hyperplasia with atrophy of oxyntic glands, driven by excessive TGF-alpha signalling through EGFR. Reduced acid secretion accompanies marked protein leakage into the lumen, producing hypoalbuminaemic oedema, and there is an increased risk of gastric adenocarcinoma. In children the same picture is linked with cytomegalovirus infection and may resolve. Cetuximab has been used to block EGFR in adults.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.