Xanthoma of the Esophagus

Bang, Chang Seok; Kim, Yeon Soo; Baik, Gwang Ho; Han, Sang Hak

doi:10.5946/ce.2014.47.4.358

Cited by 11 publications

(13 citation statements)

References 9 publications

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“…They are usually solitary lesions, but multifocal cases have been reported [13]. First described by Shafer in 1971 [1,5], only four esophageal cases have been reported [11]. Two of them occurred in patients who underwent thoracic radiotherapy for systemic non-Hodgkin lymphoma and squamous carcinoma of the tracheal carina.…”

Section: Discussion Esophagusmentioning

confidence: 99%

“…Esophageal xanthoma must be distinguished from ectopic sebaceous glands, squamous papilloma, granular cell tumor, carcinoid tumor and signet ring cell carcinoma (PAS and cytokeratin positive, opposed to CD68 positivity of xanthoma cells) [11]. Verruciform xanthomas are rare benign lesions that occur mainly in the oral cavity (70%) but can also occur in skin, especially in the anogenital area [12].…”

Section: Discussion Esophagusmentioning

confidence: 99%

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Non-gastric Gastrointestinal Xanthomas: Case Series and Literature Review

Arco

Sánchez

Aceñero

2016

JGLD

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Gastrointestinal xanthomas are infrequent non-neoplastic lesions characterized by the accumulation of foam cells in the lamina propria. They are commonly seen in association with dyslipidemia, chemotherapy or radiotherapy, and infections in immunosuppressed patients. However, no clear connection to hyperlipidemia has been found. They occur more frequently in the stomach, and are very rare in the small bowel and esophagus. We identified all cases of non-gastric xanthoma or xanthomatosis reported in the English literature by searching the PubMed database and retrospectively reviewed the clinical, endoscopic, and histopathologic features of the 11 cases of non-gastric gastrointestinal xanthomas diagnosed in our hospital. Nine lesions were located in the large bowel, one in the duodenum and one in the esophagus. All xanthomas were small (<5 mm) sessile polyps except the esophageal xanthoma, which measured 13 mm. Two cases in the large bowel and the case in the small bowel were multiple. Most patients with large bowel xanthomas had hypercholesterolemia, unlike esophageal and small bowel cases. The esophageal lesion occurred in a patient with a history of partial fundoplication due to gastroesophageal reflux disease and the small bowel case was associated to chronic atrophic gastritis with intense activity. In our search of the English literature, we found 19 cases of xanthoma or xanthomatosis in the esophagus, 13 cases in the small bowel and 61 cases in the large bowel. In conclusion, gastrointestinal xanthomas, other than the gastric ones, are rare, and are usually incidental findings. Abbreviations: AIDS: Acquired immunodeficiency syndrome; CESD: Cholesterol ester storage disease; ChT: Chemotherapy; CMV: Cytomegalovirus; GERD: Gastroesophageal reflux disease; HCL: Hypercholesterolemia; HCV: Hepatitis C virus; HPV: Human papilloma virus; MAI: Mycobacterium avium intracellulare; PCR: Polymerase chain reaction; RT: Radiotherapy.

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Section: Discussion Esophagusmentioning

confidence: 99%

Section: Discussion Esophagusmentioning

confidence: 99%

Non-gastric Gastrointestinal Xanthomas: Case Series and Literature Review

Arco

Sánchez

Aceñero

2016

JGLD

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“…Xanthoma is most likely to be confused with ectopic sebaceous glands. Macroscopically, esophageal xanthoma often manifests as white-to-yellowish, granular or verruciform lesions [ 18 ]. Therefore, it is not easy to distinguish xanthoma from ectopic sebaceous glands before the confirmation of endoscopic biopsy; at that time, ME-NBI might help distinguish them.…”

Section: Discussionmentioning

confidence: 99%

Magnifying Endoscopy for Esophageal Ectopic Sebaceous Glands

et al. 2018

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Ectopic sebaceous glands are found very rarely in the esophagus; heretofore, several cases have been reported. The sebaceous gland is originally a source of an endodermal origin; however, there have been controversies regarding whether the origin of the esophageal ectopic sebaceous gland is ectodermal or endodermal. Ectopic sebaceous glands of the esophagus usually do not cause symptoms; thus, they are often found incidentally on endoscopy for routine health screening. Endoscopic findings are characterized by single or multiple yellow patches or nodular lesions of various sizes, sometimes with small central openings. We report two cases of esophageal ectopic sebaceous glands found incidentally during endoscopy with magnifying endoscopic findings. The lesions were in the mid-esophagus and lower esophagus, respectively, and both endoscopic findings were similar as multiple yellowish patches or plaques. Magnifying endoscopy revealed the openings of the excretory ducts surrounded by circular microvessels in both cases.

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“…As such, endoscopic characteristics have been established within the Japanese population and the lesion is usually only diagnosed by endoscopic findings and without the use of biopsies. However, since esophageal xanthomas are rare, and only 17 cases have been described in the English literature before the present study 4 5 6 7 8 9 10 11 12 13 14 15 16 17 , endoscopic diagnosis of esophageal xanthomas have not been thoroughly investigated. In this study, therefore, using magnifying or image-enhanced endoscopy, we examined the endoscopic appearance of esophageal xanthomas which were diagnosed histologically in our hospital.…”

Section: Introductionmentioning

confidence: 94%

Endoscopic appearance of esophageal xanthoma

et al. 2019

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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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Xanthoma of the Esophagus

Cited by 11 publications

References 9 publications

Non-gastric Gastrointestinal Xanthomas: Case Series and Literature Review

Non-gastric Gastrointestinal Xanthomas: Case Series and Literature Review

Magnifying Endoscopy for Esophageal Ectopic Sebaceous Glands

Endoscopic appearance of esophageal xanthoma

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