Clinical Presentation

A 43-year-old man presents with substernal pressure and burning.

Double-contrast upper gastrointestinal study shows diffuse enlargement of the areae gastricae (arrows) with a polygonal shape and thickening of the rugal folds of the gastric body (small arrowhead) and antrum (large arrowhead).

Differential Diagnosis

• Hypertrophic gastritis: This is the most likely diagnosis for enlarged areae gastricae and thickened rugal folds, as well as the clinical history of substernal burning.

• Antral gastritis: