Giant gastric mucosal folds demonstrable roentgenographically are the most characteristic sign of hypertrophic gastritis. Of rare occurrence and of unusual interest in this form of gastritis is a filling defect on the greater or lesser curvature which closely resembles the defect produced by a neoplasm. Ordinarily, when the normal stomach is completely filled with an opaque medium, the curvatures are sharply outlined. Occasionally the greater curvature will show a slight serration due to the prominence of the normal mucosal folds. The lesser curvature, however, is usually smooth in contour with no serrations. This absence of serrations is due to the structural formation of the mucosal folds, which on the lesser curvature side of the stomach are closely attached to the submucosa and underlying structures. The fact that the rugae run parallel with the long axis of the stomach also tends to prevent the appearance of serrations. The mucosa of the greater curvature, on the other hand, is loosely attached, the folds are thrown into convolutions, and the rugae lie more or less obliquely, at right angles to the curvature, and are thus more likely to produce shallow serrations normally. Large pliable mucosal folds may also be observed at times on the greater curvature, producing a crenulated appearance. These ordinarily have no clinical significance. When the folds are excessively redundant they may produce a filling defect simulating a neoplasm. In hypertrophic gastritis the gastric mucosal folds are greatly thickened, indurated, and enlarged and thus tend to produce an exaggerated serration with broad, deep, sharp notches. The lesser curvature is ordinarily unchanged in appearance, notwithstanding the fact that the folds are pathologically enlarged, though occasionally in advanced hypertrophic gastritis with hyperplasia producing nodular polypoid-like excrescences, the relief roentgenogram may show some irregularity, In cases in which localized giant gastric rugae are associated with hypertrophic gastritis a filling defect may be observed on the greater curvature of the stomach resembling that caused by a neoplasm. Giant gastric rugae producing such a filling defect are rare. Kantor described two cases found in over 2,500 patients examined roentgenologically and cited Windholz as discovering 2 examples in 3,000 autopsies, and Cole and Scherer as each reporting 4 cases. The incidence of giant gastric rugae which produce a neoplastic type of filling defect on the lesser curvature must be exceedingly low. In over 25,000 patients examined roentgenologically, I have observed such a defect only once, nor have I been able to find any case in the available literature. The few cases recorded have all involved the greater curvature. Case Report A man, aged 33, was admitted to the Sinai Hospital complaining of a stomach disorder of three years& duration, with intermittent epigastric pains, which had recently become more intense, especially during the night.