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Feng L, Zhang M, Guan J, Zhang Y, Huang Y, Dong R, Zhao K, Xia S, Xiao F, Liao J. Gastric xanthelasma is a warning sign for Helicobacter pylori infection, atrophic gastritis, and intestinal metaplasia. Front Med (Lausanne) 2023; 10:1252346. [PMID: 37727758 PMCID: PMC10505714 DOI: 10.3389/fmed.2023.1252346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023] Open
Abstract
Background Contradictory evidence suggested gastric xanthelasma (GX) was associated with some upper gastrointestinal (GI) diseases. Additionally, no research has been performed on the relationship between esophageal/duodenal xanthelasma and upper GI diseases. Methods Individuals who underwent esophagogastroduodenoscopy at Tongji Hospital, Tongji Medical College, participated in this retrospective study. This study evaluated whether the risk of GX or esophageal/duodenal xanthelasma was influenced by the following gastroesophageal diseases: superficial gastritis, gastric polyp, bile reflux, peptic ulcer, reflux esophagitis, Barrett's esophagus, esophageal cancer, atrophic gastritis (AG), intestinal metaplasia (IM), dysplasia, gastric cancer, and Helicobacter pylori (H. pylori) infection. Furthermore, subgroup analysis was conducted to establish the relationship between the number of GX and upper GI diseases. Results Of the 69,071 subjects reviewed, 1,220 (1.77%) had GX, and 54 (0.08%) had esophageal/duodenal xanthelasma. There was no difference in the prevalence of upper GI diseases between patients with and without esophageal/duodenal xanthelasma. Nevertheless, compared with non-xanthelasma patients, GX patients had a greater proportion of AG, IM, dysplasia, gastric cancer, and H. pylori infection and a lower incidence of superficial gastritis (p < 0.05). The multivariate logistic regression analysis indicated AG (OR = 1.83, 95%CI: 1.56-2.16), IM (OR = 2.42, 95%CI: 2.41-2.85), and H. pylori infection (OR = 1.32, 95%CI: 1.17-1.50) were independent risk factors for GX. In addition, patients with multiple GXs had a higher rate of AG and IM than those with single GX. Conclusion Esophageal/duodenal xanthelasma may not be associated with upper GI diseases, and further research is needed to support this hypothesis. Notably, GX, especially multiple GXs, may be a more easily detected warning sign of AG, IM, or H. pylori infection.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jiazhi Liao
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Shen WN, Qu XD, Chen SS, Liu YH, Gao MJ, Shi YQ. Relationship between gastric xanthoma, gastric precancerous lesions, and gastric cancer: A retrospective study. J Dig Dis 2023; 24:340-347. [PMID: 37417403 DOI: 10.1111/1751-2980.13202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 06/27/2023] [Accepted: 07/05/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE To evaluate the relationship between gastric cancer and its precancerous lesions and gastric xanthoma. METHODS Medical records of 47 736 patients who underwent gastroscopy in our center from January 2020 to December 2021 were reviewed. Patients' age, sex, endoscopic and histopathological findings, and the presence, number and location of gastric xanthoma were recorded. To investigate the detection rate of gastric xanthoma at different stages of gastric lesions, the participants were further divided into the chronic gastritis group (n = 42 758), the precancerous lesion group (n = 3672), and the gastric cancer group (n = 1306), respectively. RESULTS The overall detection rate of gastric xanthoma was 2.85%, and it was most commonly observed in the gastric antrum (52.50%). In addition, gastric xanthoma was more common in men and more likely to be single lesion. It was most detected in the precancerous lesion group (8.39%), followed by the gastric cancer group (5.44%), and least in the chronic gastritis group (2.29%). Multivariate analysis showed that gastric xanthoma was closely related to precancerous lesions (odds ratio [OR] 3.197, 95% confidence interval [CI] 2.791-3.662, P < 0.001) and gastric cancer (OR 1.794, 95% CI 1.394-2.309, P < 0.001). CONCLUSION Gastric xanthoma is closely related to gastric precancerous lesions and gastric cancer.
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Affiliation(s)
- Wei Na Shen
- Xi'an Medical University, Xi'an, Shaanxi Province, China
| | - Xiao Dong Qu
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Sha Sha Chen
- Xi'an Medical University, Xi'an, Shaanxi Province, China
| | - Yu Huan Liu
- Xi'an Medical University, Xi'an, Shaanxi Province, China
| | - Meng Jie Gao
- Xi'an Medical University, Xi'an, Shaanxi Province, China
| | - Yong Quan Shi
- Xi'an Medical University, Xi'an, Shaanxi Province, China
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
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Greenberg MR, Shah S. An Unusual Case of a Gastric Xanthoma: A Case Report. Cureus 2022; 14:e25026. [PMID: 35719823 PMCID: PMC9199575 DOI: 10.7759/cureus.25026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/15/2022] [Indexed: 11/18/2022] Open
Abstract
Gastric xanthomas are rare tumor-like lesions, most commonly occurring in the antral region. We set out to describe a patient with a history of Barrett’s esophagus status post two radiofrequency ablations (RFAs) and an endoscopic mucosal resection (EMR) who developed a gastric xanthoma just below the Z-line with recurrent esophageal metaplasia. Histopathological confirmation of xanthomas are needed to rule out malignancy. While gastric xanthomas themselves are benign conditions, regular follow-up is recommended if there is a high index of suspicion of malignancy or alarming symptoms develop.
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Mannami T, Sakaki T, Tanaka T, Fukumoto Y, Wakatsuki T, Furutachi S, Shimizu S, Umekawa T, Mitsumune M, Nagahara H, Ikeda G, Fujiwara N. Esophageal xanthoma with nearby coexistent squamous cell carcinoma observed using magnifying endoscopy with narrow-band imaging. Clin J Gastroenterol 2022; 15:325-332. [PMID: 34994961 DOI: 10.1007/s12328-021-01583-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/21/2021] [Indexed: 11/26/2022]
Abstract
We report the case of a 63-year-old man who underwent annual surveillance esophagogastroduodenoscopy, during which a small squamous cell carcinoma and a tiny yellowish granular lesion were found in the middle esophagus, slightly apart from each other. Magnifying endoscopy with narrow-band imaging of the yellowish granular lesion showed yellowish spots and blots scattered within an approximately 2-mm area. The larger spots appeared nodular and were overlaid with tortuous microvessels. Subsequently, both the lesions were excised en masse via endoscopic submucosal dissection, and the yellowish lesion was determined to be xanthoma. Histologically, an aggregated nest of foam cells surrounded by intrapapillary capillary vessels filled the intraepithelial papillae; the foam cells also extended inferiorly, below the rete ridges, and were sparsely distributed through the lamina propria mucosae. To our knowledge, the latter finding is the first to be described in literature, which leads us to postulate that the number of foam cells in the lamina propria mucosae may affect how thick and yellow a xanthoma appears on endoscopy. We believe that this case that presents a highly detailed comparison between endoscopic and histologic findings improves our understanding of the endoscopic appearance of esophageal xanthomas and may facilitate a precise diagnosis of this rare disease.
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Affiliation(s)
- Tomohiko Mannami
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan.
| | - Tsukasa Sakaki
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Yasushi Fukumoto
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Toshiyuki Wakatsuki
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Shinichi Furutachi
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Shin'ichi Shimizu
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Tsuyoshi Umekawa
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Mayu Mitsumune
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Hanako Nagahara
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Genyo Ikeda
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, 720-0001, Japan
| | - Nobukiyo Fujiwara
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, 720-0001, Japan
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Gastric Xanthoma Is Related to the Rapid Growth of Gastric Cancer. J Clin Med 2021; 10:jcm10235704. [PMID: 34884406 PMCID: PMC8658188 DOI: 10.3390/jcm10235704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 12/21/2022] Open
Abstract
Early detection of gastric cancer is important. However, rapid growth of gastric cancers that cannot be resected endoscopically occurs even with periodic check-ups. Accordingly, we assessed factors associated with the speed of gastric cancer growth by examining historical endoscopic images. A total of 1996 gastric cancer cases were screened, and characteristics of lesions with slow and rapid growth were assessed. A total of 114 lesions from 114 patients were included in the assessment. Sixty slow-growing and fifty-four rapidly growing gastric cancers were compared. Female sex and incidence of lesions in the lower part of the stomach were significantly less frequent in the rapid-growth group than in the slow-growth group. History of endoscopic treatment tended to be more frequent in the rapid-growth group. Age, body mass index, histology, Helicobacter pylori status, and medications did not differ significantly between groups. Xanthoma was significantly related to rapid growth of gastric cancer, and map-like redness tended to be more frequent in the rapid-growth group in univariate analysis. Xanthoma was significantly related to rapid growth of gastric cancer on multivariate analysis. Further studies are warranted to clarify the pathophysiological mechanisms involved in the speed of gastric cancer growth.
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Yang XY, Fu KI, Chen YP, Chen ZW, Ding J. Diffuse xanthoma in early esophageal cancer: A case report. World J Clin Cases 2021; 9:5259-5265. [PMID: 34307576 PMCID: PMC8283587 DOI: 10.12998/wjcc.v9.i19.5259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/09/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastrointestinal xanthomas are asymptomatic and infrequent non-neoplastic lesions that commonly occur in the stomach with Helicobacter pylori-associated gastritis and rarely in the esophagus. To date, there have been no reports of esophageal xanthoma combined with esophageal cancer. Herein, we present the first case in the literature of a diffuse xanthoma complicated with early esophageal cancer. Moreover, this combination makes the endoscopic diagnosis difficult if it is not in mind. CASE SUMMARY A 68-year-old man visited our department with a 2-mo history of epigastric discomfort. He underwent surgery for gastric cancer 6 years ago. Esophagogastroduodenoscopy showed a semi-circumferential irregular yellowish-colored and granular lesion in the esophagus (30-35 cm from the incisors). Using magnifying endoscopy with narrow band imaging, aggregated minute and yellowish-colored spots with tortuous microvessels on the surface were observed, and background coloration was clearly seen in the lesion. As endoscopic biopsy suggested a histologically high-grade dysplasia; the lesion was completely resected en bloc by endoscopic submucosal dissection (ESD). The resected specimen was confirmed to be a squamous cell carcinoma in situ with extensive foamy cells in the superficial mucosal layer. Immunohistochemically, the observed foamy cells were strongly positive for CD68, which is characteristic of xanthoma. The clinical course was favorable, and no recurrence was observed 2 years and 7 mo after ESD. CONCLUSION Diffuse xanthoma concurrent with early esophageal cancer is extremely rare. The characteristic endoscopic features may assist endoscopists in diagnosing similar lesions.
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Affiliation(s)
- Xiao-Yun Yang
- Department of Gastroenterology and Hepatology, The Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
| | - Kuang-I Fu
- Department of Endoscopy, Kanma Memorial Hospital, Tokyo 325-0046, Japan
| | - Yan-Ping Chen
- Department of Gastroenterology and Hepatology, The Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
| | - Zhen-Wei Chen
- Department of Pathology, The Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
| | - Jing Ding
- Department of Gastroenterology and Hepatology, The Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
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7
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Chen HX, Yi FF, Wu YY, Qi XS. Recent advances in research of gastric xanthelasma. Shijie Huaren Xiaohua Zazhi 2021; 29:537-542. [DOI: 10.11569/wcjd.v29.i10.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Hong-Xin Chen
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China,Graduate School of Liaoning University of Traditional Chinese Medicine, Shenyang 110031, Liaoning Province, China
| | - Fang-Fang Yi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China,Graduate School of Dalian Medical University, Dalian 116044, Liaoning Province, China
| | - Yan-Yan Wu
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China,Graduate School of Jinzhou Medical University, Jinzhou 121001, Liaoning Province, China
| | - Xing-Shun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
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8
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Hathorn KE, Najdawi F, Hamilton MJ. A Retroflexed View into the Metabolic Syndrome. Gastroenterology 2020; 159:e6-e7. [PMID: 32320691 DOI: 10.1053/j.gastro.2020.03.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/29/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Kelly E Hathorn
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Fedaa Najdawi
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Matthew J Hamilton
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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9
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Sayar S, Ayranci G, Kürbüz K, Ak Ç, Tarikçi Kiliç E, Kahraman R, Atalay R, Öztürk O, Çalişkan Z, Adali G, Doganay L, Özdil K. High frequency of gastric cancer precursor lesions in patients with gastric xanthelasma: a prospective case-control study. Eur J Gastroenterol Hepatol 2020; 32:1130-1134. [PMID: 32732810 DOI: 10.1097/meg.0000000000001795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE An association of gastric cancer and precursor lesions with gastric xanthelasma has frequently been reported. However, the incidence of both gastric xanthelasma and gastric cancer precursor lesions increases with age. The aim of this study was to evaluate the frequency and characteristics of atrophic gastritis, intestinal metaplasia and dysplasia in patients with gastric xanthelasma compared to controls. MATERIAL AND METHODS Cases with gastric xanthelasma endoscopically and histopathologically were included in this prospective study. The patients included in the study were compared with age- and sex-matched controls in terms of the frequency and characteristics of atrophic gastritis, intestinal metaplasia, dysplasia and cancer. RESULTS In a series of 1892 upper endoscopies, 108 patients (5.7%) were found to have gastric xanthelasma. The average age of the patients was 61.41 ± 11.43 years. Among the patients, 58 (53.7%) were male. The frequencies of atrophic gastritis, intestinal metaplasia, dysplasia and gastric cancer in the xanthelasma group (n = 108) were 31.5, 68.5, 3.7 and 2.8%, respectively. The frequencies of atrophic gastritis, intestinal metaplasia, dysplasia and gastric cancer in the control group (n = 183) were 11.5, 31.7, 0.5 and 0.5%, respectively. Compared to the control group, the frequency of these cancer precursor lesions and the prevalence of advanced stage based on operative link on gastritis intestinal metaplasia assessment were found to be higher in the xanthelasma group (P < 0.05). CONCLUSION Gastric xanthelasma is associated with an increased frequency of gastric precancerous lesions and should be considered an important marker.
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Affiliation(s)
| | | | | | | | - Ebru Tarikçi Kiliç
- Anesthesiology, Saglik Bilimleri University Ümraniye Training and Research Hospital, İstanbul, Turkey
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10
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Gastric Xanthoma Associated with Gastric Cancer Development: An Updated Review. Can J Gastroenterol Hepatol 2020; 2020:3578927. [PMID: 32149048 PMCID: PMC7054765 DOI: 10.1155/2020/3578927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 12/23/2019] [Indexed: 02/07/2023] Open
Abstract
Gastric xanthelasma (GX) is a rare tumor-like lesion customarily found as an incidental finding due to its asymptomatic appearance. Grossly, it is a well-marked yellow-white plaque created in the lamina propria by microscopic clusters of foamy macrophages. Xanthelasma is rarely correlated with gastric hyperplastic polyps; gastric xanthomas are rare benign lesions that appear to be associated with inflammation of the gastric mucosa. Etiopathogenesis is also unclear, but it has been suggested to be involved in chronic gastritis, infection with Helicobacter pylori (H. pylori), diabetes mellitus, and hyperlipidemia. The gastric xanthoma prevalence ranges from 0.23% to 7%. Orth first described the condition in 1887. It has been found that xanthelasmas are associated with chronic gastritis, gastrointestinal anastomosis, intestinal metaplasia, and H. pylori infection. These lesions predispose patients to gastric cancer conditions. Xanthoma (GX) was reported to be a predictive marker for early gastric cancer. However, the effectiveness of these scores and xanthoma (GX) as predictive markers for early gastric cancer detected after H. pylori eradication remains unknown.
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11
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Hamada K, Uedo N, Kubo C, Tomita Y, Ishihara R, Yamasaki Y, Omori M, Arao M, Suzuki S, Iwatsubo T, Kato M, Tonai Y, Shichijo S, Matsuura N, Nakahira H, Kanesaka T, Yamamoto S, Akasaka T, Hanaoka N, Takeuchi Y, Higashino K, Okada H, Iishi H. Endoscopic appearance of esophageal xanthoma. Endosc Int Open 2019; 7:E1214-E1220. [PMID: 31579702 PMCID: PMC6773585 DOI: 10.1055/a-0966-8544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 05/22/2019] [Indexed: 02/02/2023] Open
Abstract
Background and study aims Esophageal xanthomas are considered to be rare, and their endoscopic diagnosis has not been fully elucidated. The aim of the present study was to determine the characteristics of the endoscopic appearance of esophageal xanthomas. Patients and methods This was a retrospective study of consecutive patients with histologically diagnosed esophageal xanthomas at a referral cancer center in Japan. The endoscopic appearance, by magnifying or image-enhanced endoscopy, and histological findings of esophageal xanthomas were investigated. Results Seven patients (six men and one woman) were enrolled. All of the patients had a solitary lesion, and the median size was 2 mm (range, 1 - 5 mm). Conventional white-light endoscopy showed the lesions as flat areas with yellowish spots in four cases and slightly elevated yellowish lesions in three cases. Magnifying endoscopy, performed in six patients, revealed the lesions as areas with aggregated minute yellowish spots with tortuous microvessels inside. Magnifying narrow-band imaging contrasted the yellowish spots and microvessels better than white-light endoscopy. In all lesions, histological examination showed that the yellowish spots corresponded to papillae filled with foam cells. The foam cells were strongly immunopositive for CD68, and in all lesions, CD34-positive intrapapillary capillaries surrounded the aggregated foam cells. The different morphologies of the flat and slightly elevated lesions corresponded to different densities of papillae filled with foam cells. Conclusions Magnifying endoscopy revealed minute yellowish spots with tortuous microvessels inside. These correspond well with histological findings and so may be useful in the diagnosis of esophageal xanthomas.
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Affiliation(s)
- Kenta Hamada
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan,Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Chiaki Kubo
- Department of Pathology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Yasuhiko Tomita
- Department of Pathology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Yasushi Yamasaki
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan,Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Masayasu Omori
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan,Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Masamichi Arao
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Sho Suzuki
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Taro Iwatsubo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Minoru Kato
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Yusuke Tonai
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Satoki Shichijo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Noriko Matsuura
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Hiroko Nakahira
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Takashi Kanesaka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Sachiko Yamamoto
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Tomofumi Akasaka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Noboru Hanaoka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Koji Higashino
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Hiroyasu Iishi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
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12
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Abstract
The alimentary tract serves as host to a large number of diseases. In the non-neoplastic group of disorders, conventional histochemistry continues to play an important diagnostic role. It is particularly important in recognizing specific infectious diseases, such as Helicobacter gastritis, Whipple disease, intestinal tuberculosis and other forms of mycobacteriosis, malakoplakia, intestinal spirochetosis, fungal enteritides, amebiasis, cryptosporidiosis, isosporiasis, and microsporidiosis. Those conditions and their histochemical properties are discussed in this review, along with the use of histochemistry in the characterization of structural gastrointestinal disorders. The latter include mucosal metaplasias, amyloidosis, glycogenic acanthosis of the esophagus, lymphocytic-collagenous colitis, gastric neuroendocrine hyperplasia, and pill gastritis.
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Affiliation(s)
- Patrick L Fitzgibbons
- Department of Pathology, St. Jude Medical Center, Fullerton, CA 92835, United States.
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Alzahrani M, Alqunaitir A, Alsohaibani M, Al-Rikabi AC. Gastric xanthelasma associated with hyperplastic polyp and mucosal erosions: report of an unusual case and literature review. Oxf Med Case Reports 2018; 2018:omy051. [PMID: 30151218 PMCID: PMC6101515 DOI: 10.1093/omcr/omy051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/17/2018] [Accepted: 05/26/2018] [Indexed: 01/01/2023] Open
Abstract
Gastric xanthelasma is a rare benign tumor-like lesion which is usually observed as an incidental finding due to its asymptomatic presentation. Grossly, it is a well-demarcated yellow-white plaque which is microscopically formed by clusters of foamy macrophages in the lamina propria. The pathogenesis and clinical significance are not clear. Gastric hyperplastic polyps are rarely associated with xanthelasma. Mucosal erosions also appear to have an association with the combined lesions of hyperplastic polyp and xanthelasma. Here, we report a rare case of simultaneous occurrence of gastric xanthoma with hyperplastic polyp and mucosal erosions. The lesions are observed in a 78 years old male who presented with a history of chronic anemia. The histological features together with a literature review of other similar reported cases are described and compared.
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Affiliation(s)
- Malak Alzahrani
- Department of Pathology, Histopathology Unit, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Areej Alqunaitir
- Department of Pathology, Histopathology Unit, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Mohammed Alsohaibani
- Department of Pathology, Histopathology Unit, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Ammar C Al-Rikabi
- Department of Pathology, Histopathology Unit, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
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14
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Nodular Esophageal Xanthoma: A Case Report and Review of the Literature. Case Rep Gastrointest Med 2017; 2017:1503967. [PMID: 28487782 PMCID: PMC5402229 DOI: 10.1155/2017/1503967] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/02/2017] [Indexed: 12/11/2022] Open
Abstract
Xanthomas are localized nonneoplastic lesions within tissues that may manifest as papules, plaques, or nodules. These lesions can be found anywhere along the gastrointestinal tract, commonly in the stomach and colon, and rarely in the small intestine and esophagus. Esophagogastroduodenoscopy (EGD) with biopsy is the gold standard tool for diagnosis. Here, we report a rare case of a lower solitary nodular esophageal xanthoma in an elderly black female. Correspondingly, all cases of esophageal xanthomas reported in the English medical literature were reviewed and presented with the reported case.
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Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
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16
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Is Gastric Xanthelasma an Alarming Endoscopic Marker for Advanced Atrophic Gastritis and Intestinal Metaplasia? Dig Dis Sci 2016; 61:2949-2955. [PMID: 27250981 DOI: 10.1007/s10620-016-4210-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 05/20/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND/AIM The clinical significance of gastric xanthelasmas is unknown. We conducted a case-control study in order to evaluate whether gastric xanthelasma is an indicator of advanced atrophic gastritis and intestinal metaplasia. MATERIAL AND METHOD The study was conducted among 1400 patients who underwent elective upper endoscopy. Patients with gastric xanthelasma and atrophy and/or intestinal metaplasia constituted the study group (n = 55). The control group involved patients with only atrophic gastritis and/or intestinal metaplasia (n = 50). Histopathologic findings of the groups including the distribution of atrophic gastritis and/or intestinal metaplasia, operative link on gastritis assessment score, operative link on gastritis intestinal metaplasia assessment (OLGIM) score, and presence of dysplasia and malignancy were compared. Subgroup analysis was performed in order to establish the relation between the characteristics (size, number, and localization) of xanthelasmas, atrophy, and intestinal metaplasia. RESULTS Multifocal atrophic gastritis was significantly more common in patients with a gastric xanthelasma (41.8 vs. 26.0 %, p = 0.03). Patients with multiple xanthelasmas had a significantly higher rate of intestinal metaplasia (p = 0.02) and a higher OLGIM score (p = 0.02) compared to those with a single xanthelasma. Dysplasia was detected in 8 (14.5 %) patients with a xanthelasma and 4 (8.0 %) patients without a xanthelasma (p = 0.2). CONCLUSION Gastric xanthelasma(s) is a warning endoscopic sign for the presence of multifocal atrophic gastritis and advanced intestinal metaplasia.
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17
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Gastric Xanthomatosis: A Rare Presentation of a Common Disorder. Clin Gastroenterol Hepatol 2016; 14:A18. [PMID: 26905903 DOI: 10.1016/j.cgh.2016.02.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 02/11/2016] [Accepted: 02/12/2016] [Indexed: 02/07/2023]
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18
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Feakins RM. Obesity and metabolic syndrome: pathological effects on the gastrointestinal tract. Histopathology 2016; 68:630-40. [DOI: 10.1111/his.12907] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 11/17/2015] [Indexed: 12/27/2022]
Affiliation(s)
- Roger M Feakins
- Department of Cellular Pathology; Royal London Hospital; London UK
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19
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Jhang LS, Hung CY, Shieh TY, Chang CW, Wang HY, Shih SC, Chen MJ. Ectopic sebaceous gland in the esophagus-Case reports and review of the literature. ADVANCES IN DIGESTIVE MEDICINE 2015. [DOI: 10.1016/j.aidm.2015.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Basyigit S, Kefeli A, Asilturk Z, Sapmaz F, Aktas B. Gastric Xanthoma: A Review of the Literature. ACTA ACUST UNITED AC 2015. [DOI: 10.17795/semj29569] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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21
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Tsai SJ, Lin CC, Chang CW, Hung CY, Shieh TY, Wang HY, Shih SC, Chen MJ. Benign esophageal lesions: endoscopic and pathologic features. World J Gastroenterol 2015; 21:1091-1098. [PMID: 25632181 PMCID: PMC4306152 DOI: 10.3748/wjg.v21.i4.1091] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/23/2014] [Accepted: 10/21/2014] [Indexed: 02/06/2023] Open
Abstract
Benign esophageal lesions have a wide spectrum of clinical and pathologic features. Understanding the endoscopic and pathologic features of esophageal lesions is essential for their detection, differential diagnosis, and management. The purpose of this review is to provide updated features that may help physicians to appropriately manage these esophageal lesions. The endoscopic features of 2997 patients are reviewed. In epithelial lesions, the frequency of occurrence was in the following order: glycogenic acanthosis, heterotopic gastric mucosa, squamous papilloma, hyperplastic polyp, ectopic sebaceous gland and xanthoma. In subepithelial lesions, the order was as follows: hemangioma, leiomyoma, dysphagia aortica and granular cell tumor. Most benign esophageal lesions can be diagnosed according to their endoscopic appearance and findings on routine biopsy, and submucosal lesions, by endoscopic resection. Management is generally based upon the confidence of diagnosis and whether the lesion causes symptoms. We suggest endoscopic resection of all granular cell tumors and squamous papillomas because, while rare, these lesions have malignant potential. Dysphagia aortica should be considered in the differential diagnosis of dysphagia in the elderly.
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Kim SH, Kim HS, Choi YD, Choi WS, Kim BS, Park SY, Cho SB, Park CH, Joo YE, Choi SK, Rew JS. A case of ascending colonic xanthoma presenting as a lateral spreading tumor. Intest Res 2014; 12:162-5. [PMID: 25349585 PMCID: PMC4204703 DOI: 10.5217/ir.2014.12.2.162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 09/29/2013] [Accepted: 10/28/2013] [Indexed: 01/21/2023] Open
Abstract
Gastrointestinal xanthomas are characterized by foamy cytoplasmic cells containing lipid in lamina propria, and occur almost in the gastric mucosa. Colonic xanthomas have been described in rare case. All reported colonic xanthomas were located in rectosigmoid. Rectosigmoid xanthomas have tended to exhibit small polypoid lesion, on the contrary flat in stomach. We report a case of xanthoma on ascending colon presenting as a laterally spreading tumor resected by endoscopic mucosal resection method.
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Affiliation(s)
- Sang Hun Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Hyun Soo Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Won Suk Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Ban Seok Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Seon Young Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sung Bum Cho
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Chang Hwan Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young Eun Joo
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sung Kyu Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jong Sun Rew
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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23
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Bang CS, Kim YS, Baik GH, Han SH. Xanthoma of the esophagus. Clin Endosc 2014; 47:358-61. [PMID: 25133126 PMCID: PMC4130894 DOI: 10.5946/ce.2014.47.4.358] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 10/25/2013] [Accepted: 10/29/2013] [Indexed: 12/14/2022] Open
Abstract
Xanthoma is an uncommon nonneoplastic lesion resulting from the accumulation of histiocytes. It predominantly shows cutaneous manifestations associated with dyslipidemia. However, xanthoma of the esophagus is extremely rare. To the best of our knowledge, only 14 cases have been reported thus far. The clinical significance of this lesion has not been established. However, this lesion should be distinguished grossly from ectopic sebaceous glands and small subepithelial tumors such as carcinoid and granular cell tumor. Moreover, signet ring cell carcinoma, which contains round cells with abundant cytoplasm and has similar histologic features to xanthoma, should be distinguished microscopically.
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Affiliation(s)
- Chang Seok Bang
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Yeon Soo Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Gwang Ho Baik
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Sang Hak Han
- Department of Pathology, Hallym University College of Medicine, Chuncheon, Korea
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24
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Sekikawa A, Fukui H, Maruo T, Tsumura T, Kanesaka T, Okabe Y, Osaki Y. Gastric xanthelasma may be a warning sign for the presence of early gastric cancer. J Gastroenterol Hepatol 2014; 29:951-6. [PMID: 24372908 DOI: 10.1111/jgh.12512] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM The significance of gastric xanthelasma in relation to gastric disease still remains unclear. We investigated the prevalence and significance of gastric xanthelasma in patients with atrophic gastritis and gastric cancer. METHODS A total of 3238 patients who underwent endoscopic examinations of the upper gastrointestinal tract were enrolled. We retrospectively investigated the presence of gastric xanthelasma, the severity of gastric atrophy, and the presence of gastric cancer, and examined the relationship between gastric xanthelasma and various clinicopathological features. RESULTS Gastric xanthelasma was detected in 249 (7.7%) of the 3238 patients and was significantly associated with age ≥ 65 years, male gender, open-type atrophy, and the presence of gastric cancer (P < 0.0001, P = 0.0002, P < 0.0001 and P < 0.0001, respectively). Multivariate analysis revealed that the presence of gastric cancer was independently related to the presence of gastric xanthelasma (odds ratio 6.19 [3.95-9.70], P < 0.0001). Age/sex/atrophy-matched control analysis demonstrated that the presence of gastric xanthelasma was significantly associated with the presence of gastric cancer (P < 0.0001). Moreover, the presence of xanthelasma in the upper region of the stomach was significantly associated with gastric cancer (P = 0.002). Gastric xanthelasma was observed in 50 (47.6%) of 105 patients with gastric cancer. CONCLUSION Gastric xanthelasma may serve as a warning sign for the presence of gastric cancer.
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Affiliation(s)
- Akira Sekikawa
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
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25
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Rey P, Pillot C, Bordachar J, Massoure-Sockeel MP, Corberand D, Hamant N. [Polypoid gastric xanthelasmas: an exceptional gastric polyposis]. Presse Med 2014; 43:723-6. [PMID: 24703739 DOI: 10.1016/j.lpm.2013.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 09/24/2013] [Indexed: 11/18/2022] Open
Affiliation(s)
- Philippe Rey
- Hôpital d'instruction des armées Legouest, service des maladies digestives, BP 90001, Metz cedex 3, France.
| | - Claire Pillot
- CHU Brabois, service d'hépato-gastroentérologie, 54511 Vandœuvre cedex, France
| | - Jérome Bordachar
- Hôpital d'instruction des armées Legouest, service des maladies digestives, BP 90001, Metz cedex 3, France
| | | | - Damien Corberand
- Hôpital d'instruction des armées Legouest, service des maladies digestives, BP 90001, Metz cedex 3, France
| | - Nicolas Hamant
- Centre de pathologie, 21, rempart Saint-Thiébault, BP 30558, 57009 Metz, France
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26
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Dhakal M, Dhakal OP, Bhandari D, Gupta A. Gastric xanthelasma: an unusual endoscopic finding. BMJ Case Rep 2013; 2013:bcr-2013-201017. [PMID: 24165503 DOI: 10.1136/bcr-2013-201017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Gastric xanthelasma is a rarely encountered finding in upper gastrointestinal (GI) endoscopy. It is characterised by yellowish-white plaque in the stomach especially in the antrum or the pyloric region. Histologically it consists of foamy macrophages in the lamina propria. It is a benign condition but its appearance mimics malignancy and it is found to be associated with various conditions, some of which are considered premalignant so, histological confirmation is necessary. We present a case of a 44-year-old man who presented to the medicine outpatient department for intermittent pain in epigastrium for the last 2 years. His physical examination was normal. His haematological and biochemical investigations were also normal. His upper GI endoscopy revealed yellowish-white plaque in fundus of the stomach, which was diagnosed as gastric xanthelasma by histological examination with associated chronic gastritis.
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Affiliation(s)
- Mona Dhakal
- Department of Medicine, Sikkim Manipal Institute of Medical Science, Gangtok, Sikkim, India
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27
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Ryan C, Quinn S, McDermott M. Small intestinal mucosal xanthoma in a patient with CHILD syndrome. J Clin Pathol 2013; 66:1094-5. [PMID: 23969275 DOI: 10.1136/jclinpath-2013-201770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Cliona Ryan
- Department of Histopathology, Our Lady's Children's Hospital, , Crumlin, Dublin, Ireland
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28
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Histiocytic disorders of the gastrointestinal tract. Hum Pathol 2013; 44:683-96. [DOI: 10.1016/j.humpath.2012.05.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 05/12/2012] [Accepted: 05/16/2012] [Indexed: 12/27/2022]
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29
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Affiliation(s)
- Ho Sung Park
- Department of PathologyResearch Institute of Clinical MedicineResearch Institute for Endocrine SciencesChonbuk National University Medical School Jeonju Korea
| | - Kyu Yun Jang
- Department of PathologyResearch Institute of Clinical MedicineResearch Institute for Endocrine SciencesChonbuk National University Medical School Jeonju Korea
| | - Woo Sung Moon
- Department of PathologyResearch Institute of Clinical MedicineResearch Institute for Endocrine SciencesChonbuk National University Medical School Jeonju Korea
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30
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Abstract
Hepatic xanthoma is an extremely rare lesion worldwide. We herein present a case of hepatic xanthoma that developed in a 27-year-old Taiwanese man who had participated in a clinical trial of pasireotide. This is, to the best of our knowledge, the first case of pasireotide-induced hepatic xanthoma. Following discontinuation of the drug, the tumor continued to decrease in size (98.2% decrease in tumor volume). We suggest that, in patients receiving pasireotide, the liver should be checked using periodic radiological examinations, even if the patient does not exhibit any risk factors, and that medical or surgical intervention may not be needed.
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Affiliation(s)
- Fan-Chun Meng
- Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan
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31
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Bassullu N, Turkmen I, Uraz S, Yagiz Korkmaz P, Memisoglu R, Gultekin OS, Bulbul Dogusoy G. Xanthomatous hyperplastic polyps of the stomach: clinicopathologic study of 5 patients with polypoid gastric lesions showing combined features of gastric xanthelasma and hyperplastic polyp. Ann Diagn Pathol 2012; 17:72-4. [PMID: 23020998 DOI: 10.1016/j.anndiagpath.2012.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 07/27/2012] [Accepted: 08/03/2012] [Indexed: 11/26/2022]
Abstract
Gastric xanthelasmas are uncommon benign lesions that are macroscopically well-demarcated yellow or yellow-white plaques and are microscopically formed by collections of foamy macrophages. Because gastric hyperplastic polyps may rarely be associated with xanthelasma, we aimed to report 5 cases of combined lesions showing features of gastric xanthelasma and hyperplastic polyps observed over the past 3 years at our institution among 4497 patients who underwent gastric endoscopy. The patients were 3 men and 2 women aged 45 to 78 years. The lesions were located in oxyntic mucosa, except one in the antrum, and measured 2 to 6 mm. Three patients showed associated chronic gastritis; none showed evidence of Helicobacter pylori infection. Combined lesions of hyperplastic polyp with xanthelasma appear to have an association with chronic gastritis, and the lipid accumulation may be the cause of hyperplasia in the overlying mucosa.
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Affiliation(s)
- Nuray Bassullu
- Department of Pathology, İstanbul Bilim University, Faculty of Medicine, Turkey.
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Sitarz R, Maciejewski R, Polkowski WP, Offerhaus GJA. Gastroenterostoma after Billroth antrectomy as a premalignant condition. World J Gastroenterol 2012; 18:3201-3206. [PMID: 22783043 PMCID: PMC3391756 DOI: 10.3748/wjg.v18.i25.3201] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 03/02/2012] [Accepted: 03/09/2012] [Indexed: 02/06/2023] Open
Abstract
Gastric stump carcinoma (GSC) following remote gastric surgery is widely recognized as a separate entity within the group of various types of gastric cancer. Gastrectomy is a well established risk factor for the development of GSC at a long time after the initial surgery. Both exo- as well as endogenous factors appear to be involved in the etiopathogenesis of GSC, such as achlorhydria, hypergastrinemia and biliary reflux, Epstein-Barr virus and Helicobacter pylori infection, atrophic gastritis, and also some polymorphisms in interleukin-1β and maybe cyclo-oxygenase-2. This review summarizes the literature of GSC, with special reference to reliable early diagnostics. In particular, dysplasia can be considered as a dependable morphological marker. Therefore, close endoscopic surveillance with multiple biopsies of the gastroenterostomy is recommended. Screening starting at 15 years after the initial ulcer surgery can detect tumors at a curable stage. This approach can be of special interest in Eastern European countries, where surgery for benign gastroduodenal ulcers has remained a practice for a much longer time than in Western Europe, and therefore GSC is found with higher frequency.
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Andrejić BM, Božanić SV, Šolajić NS, Djolai MA, Levakov AM. Xanthomas of the stomach: a report of two cases. Bosn J Basic Med Sci 2012; 12:127-9. [PMID: 22642597 PMCID: PMC4362435 DOI: 10.17305/bjbms.2012.2512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 03/05/2012] [Indexed: 02/03/2023] Open
Abstract
Gastrointestinal tract xanthomas are non tumor, well demarcated mucosal lesions that consist of foamy histiocytes, most commonly diagnosed in the stomach. The histologic appearance of xanthomas can resemble certain malignant lesions. After retrospective data base search, we have encountered only 2 cases of xanthomas, both in the antral part of the stomach. Lamina propria of the mucosa contained rare, chronic inflammatory infiltrate and clusters of oval and polygonal cells with abundant, foamy cytoplasm. The cytoplasm of described cells did not show the presence of mucin (Periodic acid-Schiff (PAS) and Alcian blue staining). The cells showed distinct cytoplasmic CD68 positivity and CKMNF116 negativity, which confirmed the diagnosis of xanthoma. Given the frequent association of xanthomas and known precancerous lesions of gastric mucosa, and occasional coexistence of malignant change, we need to pay attention to its diagnosis, and it is advisable to use both histochemical and immunohistochemical methods.
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Affiliation(s)
- Bojana M. Andrejić
- Department of Histology and Embryology, Faculty of Medicine, Hajduk Veljkova 3 Novi Sad, Serbia
| | - Snežana V. Božanić
- Center for Pathology and Histology, Clinical Center of Vojvodina, Hajduk Veljkova 1, Novi Sad, Serbia
- Department of Pathology, Faculty of Medicine, Hajduk Veljkova 3, Novi Sad, Serbia
| | - Nenad S. Šolajić
- Center for Pathology and Histology, Clinical Center of Vojvodina, Hajduk Veljkova 1, Novi Sad, Serbia
- Department of Pathology, Faculty of Medicine, Hajduk Veljkova 3, Novi Sad, Serbia
| | - Matilda A. Djolai
- Department of Histology and Embryology, Faculty of Medicine, Hajduk Veljkova 3 Novi Sad, Serbia
- Center for Pathology and Histology, Clinical Center of Vojvodina, Hajduk Veljkova 1, Novi Sad, Serbia
| | - Aleksandra M. Levakov
- Department of Histology and Embryology, Faculty of Medicine, Hajduk Veljkova 3 Novi Sad, Serbia
- Center for Pathology and Histology, Clinical Center of Vojvodina, Hajduk Veljkova 1, Novi Sad, Serbia
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Gastric hyperplastic polyp associated with proliferation of xanthoma cells observed by magnification narrow-band imaging endoscopy. Gastroenterol Res Pract 2009; 2009:845260. [PMID: 20029644 PMCID: PMC2796228 DOI: 10.1155/2009/845260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2009] [Accepted: 09/29/2009] [Indexed: 11/17/2022] Open
Abstract
A case of gastric hyperplastic polyp with proliferation of xanthoma cells is reported. The patient was a 69-year-old man who visited our hospital for further evaluation of gastric polyps. Endoscopic examination of the upper digestive tract revealed multiple hyperplastic polyps in the gastric antrum. There was a pedunculated polyp with whitish yellow granules, 7 mm in diameter, arising from the greater curvature of the antrum. Magnification narrow-band imaging endoscopy (GIF-H260Z, Olympus) revealed long microcapillaries in the polyp but did not reveal disappearance of the mucosal microstructure or irregular branched capillaries. Endoscopic mucosal resection (EMR) was performed. Histological examination of the specimen revealed the lengthened gastric foveolae in the superficial portion and tight sheet of foamy histiocytes in the lamina propria. Diagnosis of gastric hyperplastic polyp with proliferation of xanthoma cells was made. There was no evidence of malignancy. It is necessary to know that a gastric hyperplastic polyp may associate with gastric xanthoma, although such association is very rare.
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Vázquez Rodríguez S, Alvarez Alvarez C, Ulla Rocha JL, Fernández Salgado E, Vázquez San Luis MJ. [Gastric xanthoma on a hyperplastic polyp]. GASTROENTEROLOGIA Y HEPATOLOGIA 2009; 32:663-4. [PMID: 19525033 DOI: 10.1016/j.gastrohep.2009.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 03/18/2009] [Indexed: 11/19/2022]
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Al-Daraji WI, Varghese M, Husain EA, Abellaoui A, Kumar V. Urinary bladder xanthoma: a report of 2 rare cases highlighted with anti-CD68 antibody. J Clin Pathol 2007; 60:844-5. [PMID: 17513509 PMCID: PMC1995781 DOI: 10.1136/jcp.2005.033597] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2005] [Indexed: 11/03/2022]
Affiliation(s)
- W I Al-Daraji
- Department of Histopathology, Darent Valley Hospital, Dartford, UK.
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Al-Daraji WI, Al Razag ZA, Twaij Z. Two cases of solitary duodenal xanthelasma. J Gastroenterol 2005; 40:657; author reply 658-9. [PMID: 16007402 DOI: 10.1007/s00535-004-1602-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2004] [Accepted: 08/27/2004] [Indexed: 02/04/2023]
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