Difference between revisions of "Gastric xanthoma"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Gastric_Xanthelasma,_HE_03.jpg
| Width      =
| Caption    = Gastric xanthoma. [[H&E stain]].
| Synonyms  =
| Micro      = gastric lamina propria with lipid-laden macrophages
| Subtypes  =
| LMDDx      = [[signet ring cell carcinoma]], [[Whipple disease]], [[MAI]] infection
| Stains    =
| IHC        = CD68 +ve, AE1/AE3 -ve
| EM        =
| Molecular  =
| IF        =
| Gross      = yellowish nodule or plaque - usu. lesser curvature
| Grossing  =
| Site      = [[stomach]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Gastric xanthoma''', abbreviated ''GX'', is an uncommon benign lesion of the stomach.
'''Gastric xanthoma''', abbreviated ''GX'', is an uncommon benign lesion of the stomach.


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==Microscopic==
==Microscopic==
Features:<ref name=Ref_GLP111>{{Ref GLP|111}}</ref>
Features:<ref name=Ref_GLP111>{{Ref GLP|111}}</ref>
*Collections of gastric lamina propria with lipid-laden macrophages.
*Collections of lipid-laden macrophages within the gastric lamina propria.


DDx:
DDx:
*[[Signet ring cell carcinoma]].<ref name=pmid6284833>{{Cite journal  | last1 = Drude | first1 = RB. | last2 = Balart | first2 = LA. | last3 = Herrington | first3 = JP. | last4 = Beckman | first4 = EN. | last5 = Burns | first5 = TW. | title = Gastric xanthoma: histologic similarity to signet ring cell carcinoma. | journal = J Clin Gastroenterol | volume = 4 | issue = 3 | pages = 217-21 | month = Jun | year = 1982 | doi =  | PMID = 6284833 }}</ref>
*[[Signet ring cell carcinoma]].<ref name=pmid6284833>{{Cite journal  | last1 = Drude | first1 = RB. | last2 = Balart | first2 = LA. | last3 = Herrington | first3 = JP. | last4 = Beckman | first4 = EN. | last5 = Burns | first5 = TW. | title = Gastric xanthoma: histologic similarity to signet ring cell carcinoma. | journal = J Clin Gastroenterol | volume = 4 | issue = 3 | pages = 217-21 | month = Jun | year = 1982 | doi =  | PMID = 6284833 }}</ref>
*[[Whipple disease]].
*[[Whipple disease]].
*MAC infection.
*[[MAC infection]].


===Images===
===Images===
<gallery>
<gallery>
image:Xanthoma_histology.jpg | Xanthoma. (WC)
Image:Gastric Xanthelasma, HE 01.jpg|GX. (WC)
Image:Gastric Xanthelasma, HE 02.jpg|GX. (WC)
Image:Gastric Xanthelasma, HE 03.jpg|GX. (WC)
Image:Gastric Xanthelasma, CD68.jpg|GX - CD68. (WC)
</gallery>
<gallery>
Image:Xanthoma_histology.jpg | Xanthoma. (WC)
</gallery>
</gallery>
www:
www:
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*Panker (AE1/AE3) -ve.
*Panker (AE1/AE3) -ve.
**To exclude carcinoma.
**To exclude carcinoma.
==Sign out==
<pre>
Stomach, Cardia Lesion, Biopsy:
    - Polypoid gastric xanthoma.
    - NEGATIVE for Helicobacter-like organisms.
    - NEGATIVE for intestinal metaplasia.
    - NEGATIVE for dysplasia and NEGATIVE for malignancy.
Comment:
The histiocytes in were demonstrated with a CD68 immunostain.
An AE1/AE3 immunostain and a Ki-67 immunostain have a benign pattern.
</pre>


==See also==
==See also==
*[[Stomach]].
*[[Stomach]].
*[[Colorectal xanthoma]].


==References==
==References==

Latest revision as of 16:21, 10 December 2019

Gastric xanthoma
Diagnosis in short

Gastric xanthoma. H&E stain.

LM gastric lamina propria with lipid-laden macrophages
LM DDx signet ring cell carcinoma, Whipple disease, MAI infection
IHC CD68 +ve, AE1/AE3 -ve
Gross yellowish nodule or plaque - usu. lesser curvature
Site stomach

Prevalence uncommon
Prognosis benign

Gastric xanthoma, abbreviated GX, is an uncommon benign lesion of the stomach.

It is also known as xanthelasma and stomach lipidosis.

General

  • Uncommon.
  • Benign.

Gross/endoscopic

  • Yellowish nodule or plaque.[1]
    • Classically lesser curvature and antrum.[2]

Microscopic

Features:[1]

  • Collections of lipid-laden macrophages within the gastric lamina propria.

DDx:

Images

www:

IHC

  • CD68 +ve.
  • Panker (AE1/AE3) -ve.
    • To exclude carcinoma.

Sign out

Stomach, Cardia Lesion, Biopsy:
     - Polypoid gastric xanthoma.
     - NEGATIVE for Helicobacter-like organisms.
     - NEGATIVE for intestinal metaplasia.
     - NEGATIVE for dysplasia and NEGATIVE for malignancy.

Comment: 
The histiocytes in were demonstrated with a CD68 immunostain. 
An AE1/AE3 immunostain and a Ki-67 immunostain have a benign pattern. 

See also

References

  1. 1.0 1.1 Iacobuzio-Donahue, Christine A.; Montgomery, Elizabeth A. (2005). Gastrointestinal and Liver Pathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 111. ISBN 978-0443066573.
  2. 2.0 2.1 Drude, RB.; Balart, LA.; Herrington, JP.; Beckman, EN.; Burns, TW. (Jun 1982). "Gastric xanthoma: histologic similarity to signet ring cell carcinoma.". J Clin Gastroenterol 4 (3): 217-21. PMID 6284833.