Pediatr Gastroenterol Hepatol Nutr.  2020 Jan;23(1):110-114. 10.5223/pghn.2020.23.1.110.

Gastric Xanthoma in the Pediatric Population: A Possible Herald for Malignancy?

• Russell JD
• Peck J
• Phen C
• Linehan JL
• Karjoo S
• Nguyen J
• Wilsey MJ

• KMID: 2467900
• DOI: http://doi.org/10.5223/pghn.2020.23.1.110

Abstract

Gastric xanthoma is frequently an incidental finding on upper endoscopy in adults. Gastric xanthomas (GX) can be mistaken for malignancies and warrant prompt histologic diagnosis. The underlying etiology is not fully understood; however, it has been linked to Helicobacter pylori gastritis and gastric cancer. GX in the pediatric population is largely unreported in the literature. Because of the relative rarity, documentation with case reports are essential to provide as much data as possible to see if there is a correlation between GX and malignant potential in the pediatric population. Our group is reporting two cases, a 10-year-old male and a 7-year-old male, both who presented with chronic dysphagia, upper abdominal pain, nausea, vomiting, and loss of appetite. Upper endoscopies for both patients revealed small polypoid lesions located in the antrum with foamy histiocytes on histology, leading to the diagnosis of gastric xanthoma.

Keyword

Pediatrics; Endoscopy; Helicobacter pylori; Lipids; Stomach neoplasms

MeSH Terms

Abdominal Pain
Adult
Appetite
Child
Deglutition Disorders
Diagnosis
Endoscopy
Gastritis
Helicobacter pylori
Histiocytes
Humans
Incidental Findings
Male
Nausea
Pediatrics
Stomach Neoplasms
Vomiting
Xanthomatosis*

Figure

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  Fig. 1 Polypoid lesion near the gastric antrum as visible on upper endoscopy.

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  Fig. 2 The infiltrate in the lamina propria is composed of large foamy histiocytes with centrally-located, oval to round nuclei and open chromatin (H&E, ×200).

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  Fig. 3 Low power view shows a polypoid section of gastric mucosa with expansion of the lamina propria by numerous large cells with clear cytoplasm (H&E, ×40).

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