A Case of Gastric Xanthomatosis Scattered through Whole Gastric Mucosa

Kim, Chul Hyun; Cho, Joo Young; Lim, Sang Bok; Lee, Moon Sung; Kim, Jin Hong; Cho, Sung Won; Shim, Chan Sup

Abstract

Xanthoma is characterized by collections in the lamina propria of lipid-laden macrophages or foam cells containing cholesterol land neutral fat, forming plagues or nodules in all regions of the gastrointestinal tract. But it is most common in the stomach. Once thought to be a rare entity, gastric xantoma has been reported with increasing frequency with the advent of increasing utilization of gastrofiberscopy. Because gastric xanthoma appear to be more common in patients with gasritis, gastric ulcer, and with duodenogastric reflux after gastric surgery, mucosal damage has been presumed to play a major role in their pathogenesis. Altough cholesterol and neutral fat are the major constituents of the foam cells, there is no documented relationship between degree of hyperlipidemia or hypercholesterolmia and presence of gastric xanthoma. Gastric xanthoma may be found in any portion of the stomach, and is single or multiple, usually 1 or 2 mm in diameter, rounded or oval, circumscribed, yellow or yeallow-white, and macular or nodular. We report a case of gastric xanthomatosis diagnosed by gastrofibroscopy with forceps biopsy. There are numerous, flat or slightly raised, white or yellow white lesions that range from pinpoint size to several milimeters in diameter and that are scattered through whole gastric mucosa.