Details

Autor(en) / Beteiligte

• Quinonez, Jonathan
• Dasu, Neethi R.
• Atwal, Tegpal

Titel

Xanthoma of the Stomach: A Report of a Stable Case: 3083

Ist Teil von

• The American journal of gastroenterology, 2018-10, Vol.113 (Supplement), p.S1684-S1684

Ort / Verlag

New York: Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins

Erscheinungsjahr

2018

Link zum Volltext

Beschreibungen/Notizen

• Xanthomas are rare lesions that occur in the gastrointestinal tract. Such lesions were first discovered in 1887 and were initially described as lipid-laden macrophages in the gastric mucosa. The histology of a gastric xanthoma can resemble certain malignant lesions such as a carcinoid tumor (clear cell) or adenocarcinoma (signet ring cell). Due to the wide differential diagnosis of this entity, attention is needed as evaluation of such lesions can rule out malignant conditions. A retrospective chart review was performed [2008-2018] at a secondary medical center in order to determine the interval change in gastric xanthomas of a 39-year-old Hispanic male who had intermittent heartburn. Data was obtained from histopathological reports of the patient who underwent an esophagoduodenoscopy (EGD) with biopsy. Here, we present a case of a stable gastric xanthoma of 10 years duration. A 39-year-old male with a past medical history of morbid obesity, mild obstructive sleep hypopnea syndrome, hypertension, and intermittent heartburn. He reported gradual onset of intermittent heartburn since 2008, initially managed with omeprazole. He underwent an EGD in 2010 and results then showed the presence of gastric polyps with histopathologic features consistent with a gastric xanthoma. Initial histopathology of the sample showed the presence of lamina propria lipid-laden macrophages from the usage of cytokeratin AE 1/3, PAS/D, and mucicarmine staining. No malignancies or dysplasia were seen. He underwent another EGD in early 2011 for a re-evaluation of his symptoms and results at the time again demonstrated presence of multiple gastric polyps. Biopsies were again taken at the time and histopathological analysis showed the stable appearance of gastric xanthomas identified the previous year with the same staining techniques. The patient underwent another EGD in 2018. Biopsies were taken and histopathological analysis of samples showed the stable appearance of his gastric xanthomas diagnosed in 2008. His gastric xanthomas remained histopathologically stable with no further development of new lesions. Given the differential diagnosis of gastric xanthoma and concern of its association with premalignant conditions, clinicians need to pay attention to the diagnosis of xanthomas. In our case, gastric xanthomas were diagnosed in a 39-year-old obese Hispanic male.