GASTRIC XANTHELASMA (XANTHOMA)

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.