Intest Res.  2014 Apr;12(2):162-165. 10.5217/ir.2014.12.2.162.

A Case of Ascending Colonic Xanthoma Presenting as a Lateral Spreading Tumor

• Kim SH
• Kim HS
• Choi YD
• Choi WS
• Kim BS
• Park SY
• Cho SB
• Park CH
• Joo YE
• Choi SK
• Rew JS

• KMID: 2284903
• DOI: http://doi.org/10.5217/ir.2014.12.2.162

Abstract

Gastrointestinal xanthomas are characterized by foamy cytoplasmic cells containing lipid in lamina propria, and occur almost in the gastric mucosa. Colonic xanthomas have been described in rare case. All reported colonic xanthomas were located in rectosigmoid. Rectosigmoid xanthomas have tended to exhibit small polypoid lesion, on the contrary flat in stomach. We report a case of xanthoma on ascending colon presenting as a laterally spreading tumor resected by endoscopic mucosal resection method.

Keyword

Xanthoma; Colon, ascending; Polyps

MeSH Terms

Colon
Colon, Ascending*
Cytoplasm
Gastric Mucosa
Mucous Membrane
Polyps
Stomach
Xanthomatosis*

Figure

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  Fig. 1 Colonoscopic findings. The endoscopy showed about 15 mm sized laterally spreading tumor in the ascending colon.

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  Fig. 2 Endoscopic treatment. Endoscopic mucosal resection using saline injection and snare was conducted.

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  Fig. 3 Histopathological finding. Multiple foamy cells are noted in lamina propria (H&E stain, ×100).

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  Fig. 4 Immunohistochemical stain (IHCS) finding. Foamy cells are positive for CD68 IHCS (×100).

Reference

1. Nakasono M, Hirokawa M, Muguruma N, et al. Colorectal xanthomas with polypoid lesion: report of 25 cases. APMIS. 2004; 112:3–10. PMID: 14961968.

2. Kim CH, Cho JY, Lim SB, et al. A case of gastric xanthomatosis scattered through whole gastric mucosa. Korean J Gastrointest Endosc. 1990; 10:317–320.

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

4. Khachaturian T, Dinning JP, Earnest DL. Gastric xanthelasma in a patient after partial gastrectomy. Am J Gastroenterol. 1998; 93:1588–1589. PMID: 9732956.

5. Remmele W, Beck K, Kaiserling E. Multiple lipid islands of the colonic mucosa. A light and electron microscopic study. Pathol Res Pract. 1988; 183:336–346. PMID: 3420034.

6. Miliauskas JR. Rectosigmoid (colonic) xanthoma: a report of four cases and review of the literature. Pathology. 2002; 34:144–147. PMID: 12009096.

7. Bejarano PA, Aranda-Michel J, Fenoglio-Preiser C. Histochemical and immunohistochemical characterization of foamy histiocytes (muciphages and xanthelasma) of the rectum. Am J Surg Pathol. 2000; 24:1009–1015. PMID: 10895824.

8. Coates AG, Nostrant TT, Wilson JA, Dobbins WO 3rd, Agha FP. Gastric xanthomatosis and cholestasis. A causal relationship. Dig Dis Sci. 1986; 31:925–928. PMID: 3731984.

9. Isomoto H, Mizuta Y, Inoue K, et al. A close relationship between Helicobacter pylori infection and gastric xanthoma. Scand J Gastroenterol. 1999; 34:346–352. PMID: 10365893.

10. Moran AM, Fogt F. 70-year-old female presenting with rectosigmoid (colonic) xanthoma and multiple benign polyps - case report. Pol J Pathol. 2010; 61:42–45. PMID: 20496273.

11. Boruchowicz A, Rey C, Fontaine M, et al. Colonic xanthelasma due to glyceride accumulation associated with an adenoma. Am J Gastroenterol. 1997; 92:159–161. PMID: 8995960.