GASTRIC XANTHELASMA (XANTHOMA)
- Etiology-not known.
- Patients have evidence of duodenal reflex, varying degrees of gastritis, gastric surgery or even associated cancer.
- On endoscopy Xanthelasma appears as single or multiple well demonstrated circular or oval whitish yellow lesions measuring 1 to 2mm and rarely exceeding 5mm.
- They may develop in the setting of cholestasis and hypercholesterolemia.
- Histologically:
- Lesion consists of collection of lipid containing macrophages (xanthoma cells) in upper lamina propria immediately beneath the surface epithelium in a pavement like pattern
- Lymphocytes, plasma cells and macrophages are present along with the foam cells.
- Macrophages contain and foaming finely vacuolated cytoplasm and cells are PAS negative.
Gastric Xanthelasma: Gastric mucosa lined by columnar epithelium. Subendothelial lamina propria shows sheets of foamy macrophages. Benign mucosal glands are also seen (H&E,X50)
Gastric Xanthelasma: Gastric mucosa lined by columnar epithelium. Subendothelial lamina propria shows sheets of foamy macrophages and congested blood vessesl (H&E,X400)
Gastric Xanthelasma: Gastric mucosa lined by columnar epithelium. Subendothelial lamina propria shows sheets of foamy macrophages and congested blood vessesl (H&E,X400)
Gastric Xanthelasma: Gastric mucosa lined by columnar epithelium. Subendothelial lamina propria shows sheets of foamy macrophages and congested blood vessesl (H&E,X400)