Systemic pathology: Menetrier disease: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Systemic pathology: Menetrier disease

Sample item

A 50-year-old man has epigastric pain, weight loss and peripheral oedema with low serum albumin. Endoscopy shows giant cerebriform gastric folds in the body and fundus. Biopsy shows marked foveolar hyperplasia with few parietal cells. Which mechanism underlies this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Overexpression of TGF-alpha, activating the epidermal growth factor receptor

Menetrier disease is hypertrophic gastropathy in which excess TGF-alpha stimulates the mucous cells. Parietal cells are lost, acid falls, and protein leaks across the hyperplastic mucosa, producing hypoalbuminaemia.

Option by option

  • A. Gastrin overproduction by a pancreatic neuroendocrine tumour

    Gastrinoma causes parietal cell hyperplasia with acid hypersecretion rather than parietal loss.

  • B. Autoantibodies against parietal cells and intrinsic factor

    Autoimmune gastritis causes atrophy of the body with achlorhydria and pernicious anaemia, not giant folds.

  • C. Overexpression of TGF-alpha, activating the epidermal growth factor receptor (correct)

    Correct. Excess TGF-alpha signalling via EGFR causes foveolar hyperplasia and protein-losing gastropathy.

  • D. Loss of E-cadherin with infiltration by signet ring cells

    Diffuse gastric cancer with E-cadherin loss causes a rigid, thickened stomach, not hyperplasia with protein loss.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Overexpression of TGF-alpha, activating the epidermal growth factor receptor. Menetrier disease is hypertrophic gastropathy in which excess TGF-alpha stimulates the mucous cells.

Why is "Gastrin overproduction by a pancreatic neuroendocrine tumour" not the answer?

Gastrinoma causes parietal cell hyperplasia with acid hypersecretion rather than parietal loss.

Why is "Autoantibodies against parietal cells and intrinsic factor" not the answer?

Autoimmune gastritis causes atrophy of the body with achlorhydria and pernicious anaemia, not giant folds.

Why is "Loss of E-cadherin with infiltration by signet ring cells" not the answer?

Diffuse gastric cancer with E-cadherin loss causes a rigid, thickened stomach, not hyperplasia with protein loss.

What concept does this question test?

It tests Systemic pathology: Menetrier disease in Pathology. Parietal cells are lost, acid falls, and protein leaks across the hyperplastic mucosa, producing hypoalbuminaemia.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic pathology: Menetrier disease?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.