Clin Endosc.  2014 Jul;47(4):358-361. 10.5946/ce.2014.47.4.358.

Xanthoma of the Esophagus

• Bang CS
• Kim YS
• Baik GH
• Han SH

• KMID: 1907939
• DOI: http://doi.org/10.5946/ce.2014.47.4.358

Abstract

Xanthoma is an uncommon nonneoplastic lesion resulting from the accumulation of histiocytes. It predominantly shows cutaneous manifestations associated with dyslipidemia. However, xanthoma of the esophagus is extremely rare. To the best of our knowledge, only 14 cases have been reported thus far. The clinical significance of this lesion has not been established. However, this lesion should be distinguished grossly from ectopic sebaceous glands and small subepithelial tumors such as carcinoid and granular cell tumor. Moreover, signet ring cell carcinoma, which contains round cells with abundant cytoplasm and has similar histologic features to xanthoma, should be distinguished microscopically.

Keyword

Xanthomatosis; Esophagus; Histiocytes; Endoscopy

MeSH Terms

Carcinoid Tumor
Carcinoma, Signet Ring Cell
Cytoplasm
Dyslipidemias
Endoscopy
Esophagus*
Granular Cell Tumor
Histiocytes
Sebaceous Glands
Xanthomatosis*

Figure

• 

  Fig. 1 Endoscopic finding of esophageal xanthoma. A 3-mm yellowish granular elevated mucosal lesion in the upper esophagus.

• 

  Fig. 2 Microscopic findings of esophageal xanthoma. Large round cells with small nuclei are aggregated in the lamina propria immediately beneath the squamous epithelium (H&E stain, ×1,000).

Reference

1. Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, Tozun N. Xanthelasmas of the upper gastrointestinal tract. J Gastroenterol. 2004; 39:215–219. PMID: 15064997.

2. Remmele W, Engelsing B. Lipid island of the esophagus. Case report. Endoscopy. 1984; 16:240–241. PMID: 6510370.

3. Stolte M, Seifert E. Lipid islands in the esophagus. Leber Magen Darm. 1985; 15:137–139. PMID: 4058227.

4. Vimala R, Ananthalakshmi V, Murthy M, Shankar TR, Jayanthi V. Xanthelasma of esophagus and stomach. Indian J Gastroenterol. 2000; 19:135. PMID: 10918723.

5. Hirokawa M, Takenaka R, Takahashi A, et al. Esophageal xanthoma: report of two cases and a review of the literature. J Gastroenterol Hepatol. 2003; 18:1105–1108. PMID: 12911673.

6. Cho DS, Park HK, Park SK, et al. An esophageal xanthoma diagnosed by upper gastrointestinal endoscopy. Korean J Med. 2008; 75(Suppl 3):S784–S786.

7. Arima M. Esophageal xanthoma: report of two cases. Stomach Intest. 2008; 43:317–320.

8. Becheanu G, Dumbrava M, Arbanas T, Diculescu M, Hoyeau-Idrissi N, Fléjou JF. Esophageal xanthoma: report of two new cases and review of the literature. J Gastrointestin Liver Dis. 2011; 20:431–433. PMID: 22187711.

9. Park HS, Jang KY, Moon WS. Incidental esophageal xanthoma in a patient with ileocecal lymphoma. Dig Endosc. 2013; 25:92–93. PMID: 23286271.

10. Herrera-Goepfert R, Lizano-Soberón M, García-Perales M. Verruciform xanthoma of the esophagus. Hum Pathol. 2003; 34:814–815. PMID: 14506645.

11. Licci S, Campo SM, Ventura P. Verruciform xanthoma of the esophagus: an uncommon entity in an unusual site. Endoscopy. 2010; 42(Suppl 2):E330. PMID: 21170833.

12. Min KW, Koh JS, Lee KG, Kim HC, Jang KS, Paik SS. Verruciform xanthoma arising in the mid esophagus. Dig Endosc. 2012; 24:387. PMID: 22925303.

13. Salamanca J, Alemany I, Sosa G, Pinedo F, Hernando S, Martín-Acosta P. Esophageal verruciform xanthoma following radiotherapy. Gastroenterol Hepatol. 2012; 35:317–320. PMID: 22285788.

14. Kim YS, Jin SY, Shim CS. Esophageal ectopic sebaceous glands. Clin Gastroenterol Hepatol. 2007; 5:A23. PMID: 16904949.