Gastric xanthoma

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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.