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Gastric Xanthoma/Xanthelasma

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An uncommon lesion: gastric xanthelasma. Turk J Gastroenterol. 2005 Sep;16(3):167-70.

Although the clinical significance of gastric xanthelasmas is unclear, they are important lesions because they may be confused with malignant lesions. The etiopathogenesis is also unclear, but chronic gastritis, Helicobacter pylori (H. pylori) infection, diabetes mellitus and hyperlipidemia have been implicated. Xanthelasma is more frequent in women and its incidence increases with age. The lesions are frequently located in the stomach, and less frequently in the esophagus, duodenum and the colon. The lesions have a yellowish-white appearance, are between 0.5 and 10 mm in size and can be single or multiple. Xanthelasmas were found to be associated with chronic gastritis, gastrointestinal anastomoses, intestinal metaplasia, and H. pylori infection. These lesions are predisposing conditions for gastric cancer. Therefore, endoscopic biopsy is mandatory and careful follow-up is required. In this paper, four patients who attended hospital with abdominal pain and dyspepsia and by chance were found to have xanthelasmas on endoscopic examination are presented, and gastric xanthelasmas are discussed.

Gastric xantoma: histological findings and clinico endoscopic characteristics in the "Hospital Nacional 2 de Mayo" (1999-2005). Rev Gastroenterol Peru. 2005 Jul-Sep;25(3):268-71.

Gastric xanthoma has been associated with helicobacter pylori and chronic gastritis by many authors, some authors think the inflammation gives rise to them. This is a descriptive study in all cases of gastric xanthoma whose diagnosis was made during 1999 to June 2005, a simple statistical analysis was used. We found 26 cases, frequency peaked in those from 50-69 years of age (46.1%), gastric xanthoma was most frequently found in the antrum (69.5%), Helicobacter pylori was found in 11 cases (42.3%) and intestinal metaplasia was found in 10 (38.4%). Our results are similar to those obtained by others authors., we think chronic gastritis and gastric xanthoma share the same origin , but this affirmation must be confirmed by studies with greater statistical value.

Xanthelasmas of the upper gastrointestinal tract.: J Gastroenterol. 2004;39(3):215-9.

BACKGROUND: Gastric xanthelasma is a benign and uncommon lesion with a variably reported frequency, while esophageal and duodenal xanthelasmas are quite rare. METHODS: Seventeen patients who had the diagnosis of xanthelasma in the upper gastrointestinal tract were analyzed retrospectively with respect to their demographic, clinical, endoscopic, and histopathologic features. All lesions suspected as xanthelasma were totally removed by either hot biopsy forceps or a snare with the technique of endoscopic mucosal resection. RESULTS: The incidence of upper gastrointestinal xanthelasmas in 7320 patients who had upper gastro-intestinal endoscopy was 0.23%. There were 9 (53%) men and 8 (47%) women, with a median age of 50 years (range, 24-80 years). The most common location of xanthelasmas was the stomach (76%), followed by the esophagus (12%) and duodenum (12%). All lesions were observed as yellow-white colored plaques at endoscopy. Multiple xanthelasmas were detected in 4 patients (24%); in the duodenum in 2, esophagus in 1, and stomach in 1. One patient had xanthelasma within a gastric hyperplastic polyp. The size of the lesion was less than 5 mm in diameter in 14 (82%) patients and between 5 and 10 mm in diameter in 3 (18%). Thirteen (76%) patients had moderate to severe atrophic gastritis, while the remainder had normal gastric mucosa. CONCLUSIONS. Xanthelasmas of the upper gastrointestinal tract were mostly located in the stomach in the present series, which includes the second and third reported cases of duodenal xanthelasma, the second case of xanthelasma developed within a hyperplastic gastric polyp, and the fourth and the fifth cases of esophageal xanthelasma.

 

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NORMAL HISTOLOGY OF ESOPHAGUS

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