Mamillary State

MAMILLARY STATE, mamillary condition, a term used to denote that condition of the gastric mucosa when its surface has an uneven, uniformly granular appearance due to the protrusion of small nodules or papillae located close together [see illustration in separate table (article Stomach)]. Such a condition, usually most pronounced in the region of the gastric outlet, gives the mucous membrane a resemblance to shagreen skin. Research by Kokubo (Kokuyo) has shown that there is a physiological and pathological M.S. - The physiological M.S. represents the uniform unevenness of the surface of the mucous membrane, which is based on the uneven development of the stroma and lymphoid tissue in the mucosa, and which is often intensified by the uneven contraction of the muscularis mucosae; the distinguishing feature of physiological M.S. is the significant smoothing of the unevenness when the wall of the stomach is strongly stretched. - Pathological M.S. is one type of hypertrophic chronic gastritis of the stomach; in pathological M.S., the protruding papillae are larger and do not smooth out when the wall of the stomach is stretched, while the basis of their formation is the inflammatory hyperplasia of the stroma with its infiltration by lymphoid elements and plasma cells, along with the growth and expansion of the glands. From M.S. it is necessary to distinguish the nodular hypertrophy of the gastric mucosa (sometimes incorrectly called gastritis nodularis), in which there is a marked hyperplasia of the lymphatic follicles of the mucosa, which is a particular manifestation of the so-called status lymphaticus.