CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2018; 09(04): 149-154
DOI: 10.4103/jde.JDE_72_18
Review Article
Journal of Digestive Endoscopy

Thickened Gastric Folds: Approach

Roshan Agarwala
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Jimil Shah
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Usha Dutta
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
24. September 2019 (online)

ABSTRACT

Thickened gastric folds (TGF) are not an uncommon finding on radiological imaging or endoscopy. It is an enigmatic condition requiring a systematic approach with correlation between clinical, laboratory, radiological, endoscopic, and histological parameters to reach a final diagnosis. It has a varied number of differential diagnosis and reaching the final diagnosis is often challenging even to an astute clinician. Findings on endoscopy are similar and biopsy results often equivocal. Differentiating between benign and malignant conditions is challenging. Routine pinch biopsy usually does not sample deep enough to get an adequate tissue sample, and other methods of biopsy may be required. Newer modalities, such as endoscopic ultrasound (EUS) and EUS‑guided sampling, are helpful in differentiating benign from malignant causes. At times, exploratory laparotomy and full‑thickness biopsy may be required for final diagnosis. In this review, we discuss the various differentials of TGF, with special emphasis on how to approach a case of TGF.

 
  • REFERENCES

  • 1 Bjork JT, Geenen JE, Soergel KH, Parker HW, Leinicke JA, Komorowski RA. et al. Endoscopic evaluation of large gastric folds: A comparison of biopsy techniques. Gastrointest Endosc 1977; 24: 22-3
  • 2 Mendis RE, Gerdes H, Lightdale CJ, Botet JF. Large gastric folds: A diagnostic approach using endoscopic ultrasonography. Gastrointest Endosc 1994; 40: 437-41
  • 3 Tran T, Hung P, Laucirica R, Hilal RE, Goodgame RW. The clinical significance of thickened gastric folds found on upper gastrointestinal series. J Clin Gastroenterol 2002; 35: 138-43
  • 4 Rich A, Toro TZ, Tanksley J, Fiske WH, Lind CD, Ayers GD. et al. Distinguishing Ménétrier's disease from its mimics. Gut 2010; 59: 1617-24
  • 5 Huh WJ, Coffey RJ, Washington MK. Ménétrier's disease: Its mimickers and pathogenesis. J Pathol Transl Med 2016; 50: 10-6
  • 6 Chen CY, Jaw TS, Wu DC, Kuo YT, Lee CH, Huang WT. et al. MDCT of giant gastric folds: Differential diagnosis. AJR Am J Roentgenol 2010; 195: 1124-30
  • 7 Ménétrier P. Des polyadenomes gastriques et leur rapport avec le cancer de l'estomac. Arch Physiol Norm Pathol 1888; 1: 236e62
  • 8 Scharschmidt BF. The natural history of hypertrophic gastrophy (Menetrier's disease). Report of a case with 16 year follow-up and review of 120 cases from the literature. Am J Med 1977; 63: 644-52
  • 9 Drut RM, Gómez MA, Lojo MM, Drut R. Cytomegalovirus-associated Ménétrier's disease in adults. Demonstration by polymerase chain reaction (PCR). Medicina (B Aires) 1995; 55: 659-64
  • 10 Kawasaki M, Hizawa K, Aoyagi K, Nakamura S, Fujishima M. Ménétrièr's disease associated with helicobacter pylori infection: Resolution of enlarged gastric folds and hypoproteinemia after antibacterial treatment. Am J Gastroenterol 1997; 92: 1909-12
  • 11 Park MS, Ha HK, Choi BS, Kim KW, Myung SJ, Kim AY. et al. Scirrhous gastric carcinoma: Endoscopy versus upper gastrointestinal radiography. Radiology 2004; 231: 421-6
  • 12 De Potter T, Flamen P, van Cutsem E, Penninckx F, Filez L, Bormans G. et al. Whole-body PET with FDG for the diagnosis of recurrent gastric cancer. Eur J Nucl Med Mol Imaging 2002; 29: 525-9
  • 13 Wang XY, Wei X, Dai YH, Zhang Y, Huo JR. Large gastric folds arising in polyposis syndromes. Rev Esp Enferm Dig 2013; 105: 429-32
  • 14 Lam-Himlin D, Park JY, Cornish TC, Shi C, Montgomery E. Morphologic characterization of syndromic gastric polyps. Am J Surg Pathol 2010; 34: 1656-62
  • 15 Tan DT, Stempien SJ, Dagradi AE. The clinical spectrum of hypertrophic hypersecretory gastropathy. Report of 50 patients. Gastrointest Endosc 1971; 18: 69-73
  • 16 Komorowski RA, Caya JG. Hyperplastic gastropathy. Clinicopathologic correlation. Am J Surg Pathol 1991; 15: 577-85
  • 17 An-Foraker SH, Vise D. Cytodiagnosis of gastric carcinoma, linitis plastica type (diffuse, infiltrating, poorly differentiated adenocarcinoma). Acta Cytol 1981; 25: 361-6
  • 18 Winawer SJ, Posner G, Lightdale CJ, Sherlock P, Melamed M, Fortner JG. et al. Endoscopic diagnosis of advanced gastric cancer. Factors influencing yield. Gastroenterology 1975; 69: 1183-7
  • 19 Komorowski RA, Caya JG, Geenen JE. The morphologic spectrum of large gastric folds: Utility of the snare biopsy. Gastrointest Endosc 1986; 32: 190-2
  • 20 Bjork JT, Geenen JE, Komorowski RA, Soergel KH. Menetrier's disease diagnosed by electrosurgical snare biopsy. J Am Med Assoc 1977; 238: 1755-6
  • 21 Faigel DO, Eisen GM, Baron TH, Dominitz JA, Goldstein JL, Hirota WK. et al. Tissue sampling and analysis. Gastrointest Endosc 2003; 57: 811-6
  • 22 Lim H, Lee GH, Na HK, Ahn JY, Lee JH, Choi KS. et al. Use of endoscopic ultrasound to evaluate large gastric folds: Features predictive of malignancy. Ultrasound Med Biol 2015; 41: 2614-20
  • 23 Ginès A, Pellise M, Fernández-Esparrach G, Soria MT, Mata A, Membrillo A. et al. Endoscopic ultrasonography in patients with large gastric folds at endoscopy and biopsies negative for malignancy: Predictors of malignant disease and clinical impact. Am J Gastroenterol 2006; 101: 64-9
  • 24 Caletti G, Fusaroli P, Togliani T, Bocus P, Roda E. Endosonography in gastric lymphoma and large gastric folds. Eur J Ultrasound 2000; 11: 31-40
  • 25 Wolfsen HC, Carpenter HA, Talley NJ. Menetrier's disease: A form of hypertrophic gastropathy or gastritis?. Gastroenterology 1993; 104: 1310-9
  • 26 Carmack SW, Genta RM, Schuler CM, Saboorian MH. The current spectrum of gastric polyps: A 1-year national study of over 120,000 patients. Am J Gastroenterol 2009; 104: 1524-32
  • 27 Cronkhite Jr LW, Canada WJ. Generalized gastrointestinal polyposis; an unusual syndrome of polyposis, pigmentation, alopecia and onychotrophia. N Engl J Med 1955; 252: 1011-5
  • 28 Yanaru-Fujisawa R, Nakamura S, Moriyama T, Esaki M, Tsuchigame T, Gushima M. et al. Familial fundic gland polyposis with gastric cancer. Gut 2012; 61: 1103-4