Gastric Xanthomatosis: A Rare Presentation of a Common Disorder.
28 year old man with no known underlying disAease visited our health examination center for his first comprehensive check up. The young man was symptom free, but he wanted to know his physical condition. Therefore, he underwent a self paid upper gastrointestinal (GI) endoscopy, which showed multiple white and yellow nodular mucosal lesions with a fern like surface, most of which were located in the gastric fundus (Figures A and B) The lesions coalesced into groups. Several solitary lesions also were found in the antrum and lower corpus of the stomach. The rapid urease test was negative. Histopathology showed gastric mucosa with collections of foamy histiocytes in the lamina propria (Figure C, arrowheads indicate 2 of the foamy histiocytes) Laboratory data showed dyslipidemia (triglyceride level, 315 mg/dL [normal, <150 mg/dL] high density lipoprotein level, 22 [normal, >40 mg/ dL] On the basis of the endoscopic and histologic findings, gastric xanthomatosis was diagnosed. Xanthomas and xanthelasma are benign lesions that sometimes are found incidentally during upper GI endoscopy. The most common location of xanthomas in the upper GI tract is in the stomach (76% The condition first was described by Orth in 1887. A gastric xanthoma is a yellow plaque like lesion with lipid containing histiocytes observed on histopathologic examination. The prevalence of gastric xanthomas ranges from 0.23% to
Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association