{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.gastric-mucosal-hypertrophy","code":"thing-q975705","url":"https://ver.cy/models/thing/q975705/","name":"gastric mucosal hypertrophy","alternateNames":[],"kind":"thing","status":"published","version":"0.1.0-research.1","language":"en","classifiers":{"family":"Thing Registry","category":"Cross-cutting context","entryKind":"thing","plane":"XCT","domain":["XCT.STA"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"Gastric mucosal hypertrophy is a descriptive abnormality in which the stomach lining is thickened, often producing enlarged gastric folds, without specifying the underlying cause or establishing whether the enlargement reflects cellular hypertrophy or hyperplasia.","purpose":"Enable an agent to recognise, characterise and track gastric mucosal hypertrophy while distinguishing the observed mucosal abnormality from its possible causes and determining what further assessment is justified.","scope":{"in":["Evidence that enlargement involves the gastric mucosa rather than only deeper gastric wall layers","Distribution, extent and appearance of enlarged gastric folds or thickened mucosa","Histological architecture and the mucosal compartments contributing to enlargement","Associated gastric functional abnormalities and documented clinical consequences","Evidence supporting competing causes, diagnostic uncertainty and change over time"],"out":["Complete disease models and treatment protocols for Ménétrier disease or Zollinger-Ellison syndrome","Primary models of gastric carcinoma, lymphoma and other infiltrative diseases","Isolated gastric polyps and hereditary polyposis syndromes as independent entities","Gastric muscular hypertrophy, extrinsic compression and nonmucosal wall thickening","General endoscopy procedures, medication prescribing and whole-patient nutritional management"],"boundaries":[]},"distinguishingFeatures":["Establish which gastric wall layer is enlarged: a report of thickened gastric wall alone does not establish mucosal hypertrophy.","Distinguish persistent enlarged folds under documented examination conditions from apparent prominence associated with inadequate gastric distension.","Record whether tissue shows foveolar expansion, oxyntic gland expansion or another process; the registry label alone does not prove increased individual cell size.","Separate continuous fold enlargement from discrete polypoid lesions, documenting coexistence where present.","Do not identify the phenotype automatically as Ménétrier disease: diagnosis requires integrated clinical and histological evidence. [Diagnostic cohort](https://pubmed.ncbi.nlm.nih.gov/20926644/)"],"structure":{"bundles":[{"id":"phenotype-boundary","name":"Phenotype boundary","description":"Establish what the gastric mucosal hypertrophy label denotes in this record.","layers":[{"id":"label-interpretation","name":"Label interpretation","description":"Preserve the meaning and evidential status of the original terminology.","findings":[{"id":"descriptive-versus-diagnostic-use","name":"Descriptive versus diagnostic use","description":"Record whether the term describes enlarged mucosa, reports a pathological conclusion or stands for a specifically diagnosed disease.","questions":[{"text":"Does the originating record use gastric mucosal hypertrophy as a morphological observation or a disease diagnosis?","id":"descriptive-versus-diagnostic-use-q01","kind":"definition"},{"text":"Which report, author and examination support that interpretation?","id":"descriptive-versus-diagnostic-use-q02","kind":"provenance"}]}]},{"id":"anatomical-localisation","name":"Anatomical localisation","description":"Determine whether enlargement is demonstrably mucosal.","findings":[{"id":"mucosal-versus-wall-thickening","name":"Mucosal versus wall thickening","description":"Keep whole-wall thickening, prominent folds and demonstrated mucosal expansion as distinct observations.","questions":[{"text":"What evidence localises the enlargement to the mucosa rather than submucosa or muscularis propria?","id":"mucosal-versus-wall-thickening-q01","kind":"boundary"},{"text":"Was the reported dimension mucosal thickness, fold height or total gastric wall thickness?","id":"mucosal-versus-wall-thickening-q02","kind":"measurement"}]}]}]},{"id":"gastric-topography","name":"Gastric topography","description":"Describe where mucosal enlargement occurs and how the folds behave during examination.","layers":[{"id":"regional-extent","name":"Regional extent","description":"Map affected and apparently spared gastric regions.","findings":[{"id":"involvement-and-sparing","name":"Involvement and sparing","description":"Record the regional pattern without converting apparent sparing into an unsampled histological conclusion.","questions":[{"text":"Which gastric regions show enlarged mucosa, and is involvement focal, patchy or diffuse?","id":"involvement-and-sparing-q01","kind":"measurement"},{"text":"Is reported antral sparing based on endoscopic appearance, tissue sampling or both?","id":"involvement-and-sparing-q02","kind":"provenance"}]}]},{"id":"fold-appearance","name":"Fold appearance","description":"Capture fold morphology and the conditions under which enlargement was observed.","findings":[{"id":"persistent-fold-enlargement","name":"Persistent fold enlargement","description":"Document distension, surface appearance and the relationship between enlarged folds and discrete lesions.","questions":[{"text":"Do the folds remain enlarged with documented adequate gastric distension?","id":"persistent-fold-enlargement-q01","kind":"measurement"},{"text":"Are the abnormalities continuous rugal folds, discrete polyps or a mixture?","id":"persistent-fold-enlargement-q02","kind":"boundary"},{"text":"Are mucus, erosions, ulceration or contact bleeding recorded at the affected sites?","id":"persistent-fold-enlargement-q03","kind":"measurement"}]}]}]},{"id":"mucosal-architecture","name":"Mucosal architecture","description":"Characterise the tissue basis of enlargement and the limits of sampled evidence.","layers":[{"id":"compartment-pattern","name":"Compartment pattern","description":"Identify the anatomical components contributing to increased mucosal bulk.","findings":[{"id":"epithelial-and-stromal-contributions","name":"Epithelial and stromal contributions","description":"Record foveolar and glandular architecture separately from edema, inflammation and abnormal infiltrates. Architectural and inflammatory distinctions have been examined in gastric foveolar lesions. [Histological study](https://pubmed.ncbi.nlm.nih.gov/9368593/)","questions":[{"text":"Which compartments are expanded, and are glandular dilation, tortuosity or atrophy documented?","id":"epithelial-and-stromal-contributions-q01","kind":"measurement"},{"text":"Does the specimen demonstrate hyperplasia, individual-cell hypertrophy, edema, infiltration or an unresolved combination?","id":"epithelial-and-stromal-contributions-q02","kind":"definition"}]}]},{"id":"sampling-confidence","name":"Sampling confidence","description":"Assess whether tissue depth and site coverage answer the diagnostic question.","findings":[{"id":"architectural-assessment-adequacy","name":"Architectural assessment adequacy","description":"Record specimen depth, orientation and site matching. A diagnostic study of suspected Ménétrier disease emphasised full-thickness mucosal sampling within an integrated evaluation. [Diagnostic cohort](https://pubmed.ncbi.nlm.nih.gov/20926644/)","questions":[{"text":"Does the sample preserve the full mucosal architecture needed for the proposed interpretation?","id":"architectural-assessment-adequacy-q01","kind":"measurement"},{"text":"Were samples taken from the enlarged folds and labelled by gastric region?","id":"architectural-assessment-adequacy-q02","kind":"provenance"},{"text":"Does inadequate or discordant tissue evidence justify clinician consideration of additional sampling or pathology review?","id":"architectural-assessment-adequacy-q03","kind":"action"}]}]}]},{"id":"functional-consequences","name":"Functional consequences","description":"Relate the mucosal abnormality to protein handling, secretion and documented clinical burden.","layers":[{"id":"protein-loss-assessment","name":"Protein loss assessment","description":"Separate observed protein depletion from evidence identifying its source.","findings":[{"id":"gastric-protein-loss-attribution","name":"Gastric protein loss attribution","description":"Record albumin and edema alongside the evidence for gastrointestinal loss and any alternative explanations.","questions":[{"text":"What are the dated albumin measurements and documented findings of edema or nutritional decline?","id":"gastric-protein-loss-attribution-q01","kind":"measurement"},{"text":"What evidence attributes protein depletion to gastric loss rather than another gastrointestinal, renal, hepatic or nutritional process?","id":"gastric-protein-loss-attribution-q02","kind":"boundary"}]}]},{"id":"secretion-and-symptoms","name":"Secretion and symptoms","description":"Document gastric functional testing and symptoms without assuming that fold size determines either.","findings":[{"id":"secretory-and-clinical-profile","name":"Secretory and clinical profile","description":"Capture measured acidity, gastrin where assessed, medication context and the temporal relationship of symptoms to mucosal findings.","questions":[{"text":"What gastric pH, acid-output or gastrin results are available, and under what testing and medication conditions?","id":"secretory-and-clinical-profile-q01","kind":"measurement"},{"text":"Are pain, vomiting, early satiety, bleeding or weight change temporally associated with the gastric abnormality?","id":"secretory-and-clinical-profile-q02","kind":"measurement"},{"text":"Which documented functional consequences require clinician assessment before routine follow-up?","id":"secretory-and-clinical-profile-q03","kind":"action"}]}]}]},{"id":"causal-differentiation","name":"Causal differentiation","description":"Organise evidence for underlying gastropathies and competing explanations.","layers":[{"id":"gastropathy-patterns","name":"Gastropathy patterns","description":"Compare candidate diagnoses using their required evidence.","findings":[{"id":"menetrier-pattern-assessment","name":"Ménétrier pattern assessment","description":"Assess the combination of distribution, foveolar architecture, parietal-cell findings and functional evidence; enlarged folds alone are insufficient. [Diagnostic cohort](https://pubmed.ncbi.nlm.nih.gov/20926644/)","questions":[{"text":"Which clinical, endoscopic and histological observations support or contradict Ménétrier disease?","id":"menetrier-pattern-assessment-q01","kind":"boundary"},{"text":"Has a clinician established a specific gastropathy diagnosis, or does the record remain a descriptive phenotype?","id":"menetrier-pattern-assessment-q02","kind":"provenance"}]}]},{"id":"alternative-explanations","name":"Alternative explanations","description":"Preserve unresolved infectious, inflammatory, secretory, polypoid and infiltrative possibilities.","findings":[{"id":"competing-cause-evidence","name":"Competing cause evidence","description":"Maintain supporting and conflicting observations for each clinically raised alternative, distinguishing an unperformed test from an adequate negative result.","questions":[{"text":"What evidence addresses clinically suspected hypersecretory disease, infection, inflammatory disease, polyposis or neoplasia?","id":"competing-cause-evidence-q01","kind":"boundary"},{"text":"For each relevant negative result, were the method, anatomical site and sample adequacy sufficient to address the suspected process?","id":"competing-cause-evidence-q02","kind":"provenance"},{"text":"Which unresolved alternative most materially changes the next clinician-led assessment?","id":"competing-cause-evidence-q03","kind":"action"}]}]}]},{"id":"course-and-review","name":"Course and review","description":"Track the gastric phenotype and the decisions attached to unresolved findings.","layers":[{"id":"serial-comparison","name":"Serial comparison","description":"Compare examinations using matched locations and interpretable measurement conditions.","findings":[{"id":"morphological-functional-trajectory","name":"Morphological and functional trajectory","description":"Track fold appearance, tissue findings and functional consequences independently, relating changes to dated interventions without asserting causation.","questions":[{"text":"Are repeat observations comparable by gastric site, modality, distension and sampling depth?","id":"morphological-functional-trajectory-q01","kind":"measurement"},{"text":"Have mucosal enlargement, albumin abnormalities and symptoms changed together or diverged?","id":"morphological-functional-trajectory-q02","kind":"measurement"},{"text":"Which interventions or exposures preceded the changes, and what limits causal attribution?","id":"morphological-functional-trajectory-q03","kind":"provenance"}]}]},{"id":"review-triggers","name":"Review triggers","description":"Record the evidence and responsibility for further assessment.","findings":[{"id":"unresolved-lesion-follow-up","name":"Unresolved lesion follow-up","description":"Tie review to documented findings and any established underlying disease, without assigning a universal surveillance schedule to the phenotype.","questions":[{"text":"Are progressive thickening, unexplained bleeding, persistent ulceration or discordant pathology awaiting review?","id":"unresolved-lesion-follow-up-q01","kind":"action"},{"text":"What clinician-defined follow-up addresses each unresolved gastric finding, and who is responsible?","id":"unresolved-lesion-follow-up-q02","kind":"action"},{"text":"Does a proposed surveillance schedule derive from an established disease diagnosis or only from this descriptive label?","id":"unresolved-lesion-follow-up-q03","kind":"boundary"}]}]}]},{"id":"evidence-and-external-alignment","name":"Evidence and external alignment","description":"What the world already says about this thing, gathered so the model can be checked against it.","layers":[{"id":"reported-evidence","name":"Reported evidence","description":"Findings from the breadth pass, kept separate from the structural claims.","findings":[{"id":"evidence-confidence-notes","name":"Check these first","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these check these first hold for the sense of gastric mucosal hypertrophy this model covers, and on what evidence?","id":"evidence-confidence-notes-q01","kind":"provenance"}]},{"id":"evidence-kinds","name":"Kinds and varieties","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these kinds and varieties hold for the sense of gastric mucosal hypertrophy this model covers, and on what evidence?","id":"evidence-kinds-q01","kind":"provenance"}]},{"id":"evidence-real-world-use","name":"Real-world use","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these real-world use hold for the sense of gastric mucosal hypertrophy this model covers, and on what evidence?","id":"evidence-real-world-use-q01","kind":"provenance"}]},{"id":"evidence-failure-modes-and-hazards","name":"Failure modes and hazards","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these failure modes and hazards hold for the sense of gastric mucosal hypertrophy this model covers, and on what evidence?","id":"evidence-failure-modes-and-hazards-q01","kind":"provenance"}]},{"id":"evidence-neighbours","name":"Neighbouring kinds and how to tell them apart","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these neighbouring kinds and how to tell them apart hold for the sense of gastric mucosal hypertrophy this model covers, and on what evidence?","id":"evidence-neighbours-q01","kind":"provenance"}]}]}]}]},"agentConduct":{"may":["Explain the finding and its possible causes in general terms from reputable medical sources.","Help a person prepare questions for their doctor about an endoscopy report."],"mustNot":["Interpret an endoscopy or scan report as a diagnosis for a person.","Tell a person the finding is or is not cancer.","Recommend medicines or diet changes for a specific person.","Disclose a person's endoscopy results without consent."],"requiresHuman":["Treatment decisions, including surgery."]},"ethics":{"considerations":["A vague finding can cause anxiety; honest explanation helps more than reassurance or alarm.","Some causes are serious and need follow-up, which delay can harm."],"affectedParties":["Patients","Families","Referring clinicians"]},"owners":{"steward":"Nobody owns the finding; patients and their clinicians answer for care.","roles":[],"masterSystems":[]},"relations":[{"target":"Q16958168","type":"parent","note":"registry parent class"},{"target":"Q55785259","type":"parent","note":"registry parent class"},{"target":"Q55785595","type":"parent","note":"registry parent class"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.gastric-mucosal-hypertrophy","Wikidata: Q975705 (https://www.wikidata.org/wiki/Q975705)"]},"properties":{"applicability":"not-applicable","items":["Phenotype confirmation: suspected; mucosal enlargement documented; indeterminate; alternative explanation established","Gastric distribution: cardia; fundus; body; incisura; antrum; pylorus; multiple sites; unknown, with focal or diffuse extent","Mucosal thickness: mm, with anatomical site, modality, specimen orientation or distension conditions, and date","Fold morphology: enlarged; tortuous; nodular; polypoid; distension-responsive; distension-persistent; not assessed","Dominant histological compartment: foveolar; oxyntic glandular; mixed; stromal or inflammatory; indeterminate","Tissue sampling adequacy: adequate for the stated question; superficial; poorly oriented; geographically limited; unassessed","Serum albumin: g/L, with laboratory reference interval and date","Gastric secretory assessment: gastric pH or acid output in mmol H+/h, with collection method and medication context","Candidate underlying condition: linked condition with supporting evidence, conflicting evidence and suspected or established status","Longitudinal phenotype: newly detected; persistent; regressing; resolved; recurrent; progressing; not comparable"]},"recognition":{"applicability":"optional","items":["At endoscopy, enlarged, thick folds in the stomach lining."]},"capabilities":{"applicability":"required","items":["Assemble a site-matched account of endoscopic, imaging and histological evidence for mucosal enlargement.","Identify when uncertain wall-layer localisation or inadequate biopsy depth limits diagnostic conclusions.","Compare candidate causes against the observed distribution, architecture and functional findings.","Flag documented bleeding, nutritional deterioration or unresolved suspicious lesions for clinician review.","Track morphological and functional changes after documented interventions without assuming causation.","Link an established underlying disease to its own model while retaining the gastric phenotype record."]},"hazards":{"applicability":"required","items":["Can be a sign of conditions that cause protein loss or ulcers.","Can be confused with cancer or lymphoma, which need tissue samples to rule out."]},"interfaces":{"applicability":"required","items":["The International Classification of Diseases, issued by the World Health Organization, provides a framework for coding documented gastric disorders, with the appropriate category depending on the established diagnosis."]},"context":{"applicability":"required","items":["Gastric mucosal hypertrophy is encountered in reports describing thickened stomach lining or enlarged gastric folds during gastrointestinal assessment.","The term records an observed abnormality and supports comparison with biopsy findings and clinical context without identifying its underlying cause."]}},"sources":[{"title":"Wikidata item Q975705: gastric mucosal hypertrophy","url":"https://www.wikidata.org/wiki/Q975705","note":"identity and sense of the item"},{"title":"Wikipedia: Ménétrier's disease","url":"https://en.wikipedia.org/wiki/M%C3%A9n%C3%A9trier%27s_disease","note":"general description of the item"}],"openQuestions":["Does the registry intend gastric mucosal hypertrophy as a broad morphological phenotype, a category of hypertrophic gastropathies or a historical synonym for a specific disease?","What site-specific and modality-specific criteria reliably distinguish pathological mucosal enlargement from normal fold variation, and are validated quantitative thresholds available?","What sampling depth and regional coverage are sufficient for each suspected cause when routine biopsies are nondiagnostic?","Which associated infections, medications or secretory abnormalities have evidence of causation rather than coexistence in particular presentations?","What follow-up is supported for persistent unexplained mucosal hypertrophy when no specific gastropathy or neoplastic process has been established?"],"resources":{"spec":"/models/things/publications/thing-q975705/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q975705/spec.json"],"providers":["Codex"],"researchStatus":"unreviewed","generatedAt":"2026-09-12T09:57:21Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"not-applicable","interaction.recognition":"filled","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-07T10:10:33+00:00: completeness 1.00; sense: Wikidata description; 2 live sources; review by codex: pass","interaction.properties":"Plane XCT: no invented physical properties."},"score":1.0}}