A 60-year-old man with epigastric pain and early satiety undergoes barium meal. The study reveals markedly enlarged, tortuous gastric folds with a 'cerebriform' (brain-like) pattern, predominantly in the body and fundus, with sparing of the antrum. There is no definite ulcer or mass. Which diagnosis is MOST likely?

• A Zollinger-Ellison syndrome
• B Gastric lymphoma
• C Granulomatous gastritis
• D Menetrier disease ✓

Explanation

Menetrier disease (hypertrophic gastropathy) classically shows massively enlarged, tortuous gastric folds producing a cerebriform pattern, predominantly in the body and fundus with antral sparing, due to hyperplasia of mucus-secreting cells and hypochlorhydria. Gastric lymphoma produces thickened folds but is more nodular and may show ulceration. Zollinger-Ellison syndrome produces generalized gastric fold thickening with duodenal and jejunal ulcers, not a cerebriform body-fundus pattern. Granulomatous gastritis shows focal or diffuse nodularity, not cerebriform folds.

Reference: Gore and Levine's Textbook of Gastrointestinal Radiology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.