1. Answer: 5. Hypertrophic gastritis
Total gastrectomy:
Foveolar hyperplasia and glandular hyperplasia
 Hypertrophic hypersecretory gastropathy (Hypertrophic gastritis)

2. Imaging findings (CT, EUS, EGD)
Markedly thickened, lobulated folds in the gastric fundus and body
Preservation of wall stratification without submucosal thickening
Clear perigastric fat plane

3. Thickened Gastric Folds : DDx.
Cause
Distribution
Comments
Benign conditions
Hypertrophic gastritis
Fundus and Body
Increased acid secretion
Menetrier’s disease
Hypochlorhydria and Hypoproteinemia
Zollinger-Ellison syndrome
Hypergastrinemia resulting from non-beta islet cell tumors
Varices
Fundus and Cardia
Serpentine folds. Portal HTN or splenic v. obstruction
Eosinophilic gastritis
Antrum
Peripheral eosinophilia
Sarcoidosis
Pulmonary sarcoidosis
Amyloidosis
Systemic amyloidosis
Malignant Conditions
Lymphoma
Localized or Diffuse
May have generazlied lymphoma
Carcinoma
Ass. Narrowing and regidity of stomach
Gore and Levine, Textbook of Gastrointestinal Radiology, 3rd edition, p728

4. MDCT of Thickened gastric folds: DDx.
Loss of wall stratification would be a predictor of the presence of malignancy in patients with thickened gastric folds
A, B: normal gastric wall
C: Scirrhous gastric carcinoma, D: Malignant lymphoma –Absence of wall stratification
E: Acute gastric mucosal lesion, F: Menetrier’s disease –Preservation of wall stratification
AJR 2010; 195: