Gastric xanthelasma: an unusual endoscopic finding

Abstract

Gastric xanthelasma is a rarely encountered finding in upper gastrointestinal (GI) endoscopy. It is characterised by yellowish-white plaque in the stomach especially in the antrum or the pyloric region. Histologically it consists of foamy macrophages in the lamina propria. It is a benign condition but its appearance mimics malignancy and it is found to be associated with various conditions, some of which are considered premalignant so, histological confirmation is necessary. We present a case of a 44-year-old man who presented to the medicine outpatient department for intermittent pain in epigastrium for the last 2 years. His physical examination was normal. His haematological and biochemical investigations were also normal. His upper GI endoscopy revealed yellowish-white plaque in fundus of the stomach, which was diagnosed as gastric xanthelasma by histological examination with associated chronic gastritis.

Figure 1

(A) Endoscopic image showing a yellowish-white plaque lesion (xanthelasma) in the fundus of the stomach (134×111DPI). (B) Endoscopic image showing a yellowish-white plaque lesion (xanthelasma) in the fundus of stomach (132×111DPI).

Figure 2

Photomicrograph showing cluster of foam cells in the biopsy tissue (H&E staining).

Figure 3

Photomicrograph showing chronic inflammatory cells suggestive of chronic gastritis in the biopsy tissue from the fundus adjacent to the xanthelasma lesion (H&E staining).