Upper Gastrointestinal Xanthomas- A Retrospective Clinicopathological Review of 16 Cases

Abstract

Xanthoma in the gastrointestinal tract are rare lesions and are detected incidentally. Xanthoma cells have abundant clear cytoplasm and are seen in sheets in the mucosa or submucosa, and is a mimic various neoplastic and non-neoplastic entities. The present study aims to describe clinicopathological characters of upper gastrointestinal xanthomas. A 10-year retrospective archival search identified 16 cases of upper gastrointestinal xanthomas. The patients were mostly males with an age range of 43-73 years. Most patients presented with abdominal pain (12/16). Gastric antrum (11/16) was the most common site with sessile lesions (5/16) on endoscopy. Associated findings included, H. pylori infection (7/16), intestinal metaplasia (4/16) and chronic gastritis (3/16). Two cases showed adjacent low-grade dysplasia, however follow up did not show any progression. Literature regarding gastrointestinal xanthomas is limited, making the management strategies ambiguous. Most are benign and incidental however owing to reports of associated dysplasia a follow up is imperative in these cases.

Keywords

• xanthoma
• foam cells
• endoscopy
• gastric antrum
• h. pylori