Gastric xanthelasma: an unusual endoscopic finding

Dhakal, Mona; Dhakal, Om Prakash; Bhandari, Dhurba; Gupta, Amlan

doi:10.1136/bcr-2013-201017

Cited by 10 publications

(20 citation statements)

References 10 publications

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“…Gastric xanthelasma, characterized by lipid accumulation in histiocytic foam cells, was a relatively scarce endoscopic finding, with prevalence varied from 0.8% to 7% in different study population[ 1 - 3 ]. As is frequently observed in the gastric mucosa of patients with early gastric cancer, xanthelasma was assumed to be a predictive biomarker or pre-tumorigenesis change of gastric adenocarcinoma[ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Gastric xanthelasma and metabolic disorders: A large retrospective study among Chinese population

Chen¹,

He²,

Zhou³

et al. 2017

WJG

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AIMTo gain knowledge of xanthelasma, a large population-based study was conducted.METHODSPatients who underwent upper gastrointestinal endoscopy at the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China during Jan 2009 to Nov 2016 were included. General characteristics as well as clinical data were collected, including blood routine, serum biochemical analysis, endoscopic findinds, histological evaluation and comorbiditie. Statistical analyses was performed using SPSS 20.0 software for Windows (IBM Inc., Chicago, IL, United States) using Student’s t-test, Mann-Whitney U test, χ2 test, univariable and multivariable logistic analysis. 2-tailed P value less than 0.05 was considered to be statistically significant.RESULTSA total of 176006 endoscopies were retrieved and we included 1370 xanthelasma participants (703 men, 667 women) in this study. Prevalence of xanthelasma was 0.78% with average age of 56.6 ± 11.2 years. Chief complaint of xanthelasma consisted abdominal pain (24.2%), up-abdominal discomfort (14.1%), abdominal distention (10.1%), dyspepsia (9.1%), et al. Most xanthelasma occurred as single lesion in gastric antrum. Xanthelasma patients witnessed higher Helicobacter pylori (H. pylori) infection rate, more of other gastric lesions including atrophy, intestinal metaplasia and dysplasia (P < 0.01). In xanthelasma patients, serum carcinoembryonic antigen, triglyceride, fasting glucose, neutrophil, neutrophil-to-lymphocyte ratio were significantly higher, and high density lipoprotein-cholesterol, lymphocyte was lower (P < 0.05). Xanthelasma accompanied with more fatty liver disease and hepatic cyst, but fewer gallbladder polyp (P < 0.05). In logistic regression, it revealed that fasting plasma glucose (OR = 3.347, 1.170-9.575, P < 0.05), neutrophil (OR = 1.617, 1.003-2.605, P < 0.05), and carcinoembryonic antigen (OR = 2.011, 1.236-3.271, P < 0.01) were all independent risk factors in xanthelasma.CONCLUSIONCurrent study described a large xanthelasma cohort in Chinese population, revealed its relationship with H. pylori infection, carcinogenesis, metabolic dysfunction and inflammation as well.

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Section: Introductionmentioning

confidence: 99%

Gastric xanthelasma and metabolic disorders: A large retrospective study among Chinese population

Chen¹,

He²,

Zhou³

et al. 2017

WJG

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“…Electron microscopy demonstrated foam cells with fatty cytoplasm, as seen in Figure 4 [1-2]. Treatment involves endoscopic mucosal resection and for larger lesions, duodenal preserving surgery [3].…”

Section: Discussionmentioning

confidence: 99%

Duodenal Xanthoma: From Specks to Obstruction

Kolli

Phan²,

Ona

2019

Cureus

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Xanthomas within the gastrointestinal tract occur secondary to a mucosal insult. When enough cells accumulate, their appearance can range from small nodules studding the intestinal mucosa to bandlike infiltrations to pseudotumor-like masses within the intestine with fibrosis and inflammation resembling malignancy. When large enough, they can produce symptoms of obstruction such as vomiting, abdominal pain, distention, and dysmotility. This case demonstrates the epidemiology, clinical presentation, diagnosis, and treatment of duodenal xanthomas.

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“…The aetiology, pathogenesis and clinical significance of GX in relation to other gastric diseases remain unclear [ 2 ]. It is believed that the gastric mucosa affected by certain pathological processes is more prone to develop GX and for this reason, it is mandatory to look for other accompanying premalignant conditions [ 2 ]. The close relationship between H. pylori infection and GX has been described in various studies.…”

Section: Discussionmentioning

confidence: 99%

“…Gastric xanthomas (GX) are rare, non-neoplastic incidental findings with an incidence ranging from 0.2 to 0.8% [ 1 ]. The pathogenesis and clinical significance of GX are not clear [ 2 ]. Endoscopically, these lesions usually present as well-demarcated round, yellow-white plaques.…”

Section: Introductionmentioning

confidence: 99%

“…Endoscopically, these lesions usually present as well-demarcated round, yellow-white plaques. Microscopically, GX is characterized by collections of foamy macrophages in the lamina propria [ 2 ]. Histological confirmation of GX is mandatory because its appearance may mimic malignancy and once the histological diagnosis of GX is confirmed, it is necessary to look for accompanying premalignant conditions such as chronic gastritis, Helicobacter pylori associated gastritis, intestinal metaplasia, atrophic gastritis and gastric dysplasia [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Gastric xanthelasma associated with hyperplastic polyp and mucosal erosions: report of an unusual case and literature review

Alzahrani

Alqunaitir

Al-Sohaibani

et al. 2018

Oxford Medical Case Reports

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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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Gastric xanthelasma: an unusual endoscopic finding

Cited by 10 publications

References 10 publications

Gastric xanthelasma and metabolic disorders: A large retrospective study among Chinese population

Gastric xanthelasma and metabolic disorders: A large retrospective study among Chinese population

Duodenal Xanthoma: From Specks to Obstruction

Gastric xanthelasma associated with hyperplastic polyp and mucosal erosions: report of an unusual case and literature review

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