Elastosis and Elastofibromatous Change in the Gastrointestinal Tract A Clinicopathologic Study of 13 Cases and a Review of the Literature

Abstract

We describe 13 cases in which the submucosa and muscularis mucosae of the gastrointestinal tract exhibited a focal or diffuse increase of elastin fibers. This elastosis or elastofibromatous change most commonly manifested as a colonic polyp and usually was found during screening colonoscopy. Gastric and small intestinal cases were less frequent and associated with ulcers or an inflammatory process. The literature includes reports of 13 gastrointestinal elastotic lesions with a topographic distribution similar to that in our series. Histologically, elastosis appears as finely granular and/or fibrillar amphophilic material, sometimes with a fibrous component (elastofibromatous change). The changes occasionally appear centered around blood vessels and often are mistaken for amyloid but are negative for Congo red stain and strongly positive for elastin stain. We believe that this lesion might be more underrecognized than rare. In 2 of 26 cases, elastotic lesions also were present in nongastrointestinal sites.

Elastofibromatous Changes in Tissues From Spinal Biopsies. A Degenerative Process Afflicting a Small but Important Subset Of Patients Operated for Spinal Canal Compression: Report of 18 Cases

“…Rather, visceral elastofibromas and elastofibroma-like lesions are suggested to be associated either with ulcerative and/or inflammatory processes or with elastic degeneration of submucosal blood vessels. 22 Elastofibromas of the dorsal spine may be speculated to arise from several structures. First, they may originate from vertebral periosteum or adjacent fibrous tissue in the same way as subscapular elastofibromas.…”

Minute colonic elastosis showing endoscopic features of hyperplastic polyp

“…The cause of colonic elastosis remains unclear. 1 However, our case suggests that progressive elastic degeneration of the superficial submucosal vessels ultimately causes colonic elastosis. Endoscopists and pathologists should be aware…”

“…In the literature, 20 cases of elastosis and elastofibromatous change have been reported in the colon. 1 Colonic elastosis (CE) most commonly manifests as a colonic polyp and is usually found during screening endoscopy. These colonic polyps are reported to be yellow or lipoma-like.…”

“…1 In the homozygous state, which occurs in only 1 in 1 million people, atherosclerosis progresses much more rapidly, producing cardiovascular disease and even causing death within the first two decades of life. LDL apheresis was introduced even for small children, but it has many difficulties such as long-term maintenance of blood access and a poor quality of life.…”

“…These colonic polyps are reported to be yellow or lipoma-like. 1 Recently, we encountered a rare case of CE with a pale color and multiple sessile polypoid lesions. Histologically, minute elastosis and some elasto-degenerative vasculature were recognized in a polypectomy specimen.…”