Xanthelasma of Upper Gastrointestinal Tract: A Single Centre Study

Abstract

Background: Gastric xanthelasma is a benign and uncommon lesion incidentally identified during endoscopy. It can be suspected by the characteristic gross appearance of yellowish-white plaque or nodule and is confirmed by microscopic examination. Histologically, the lamina propria contains foamy macrophages. Although it is a benign condition, its appearance may mimic early malignancy, and it is found to be associated with various conditions, some of which are considered pre-malignant. The terms xanthelasma and xanthoma are usually used interchangeably. Aim: To determine the prevalence of xanthelasma of the upper gastrointestinal tract in subjects undergoing endoscopy. Methods: This is an observational study conducted for a period of 1 year & 8 months at Yashoda Hospitals, India. A total of 6959 endoscopies were performed, 38 xanthelasmas identified and confirmed by histopathological examination. Results: The prevalence of upper gastrointestinal (GI) xanthelasmas in 6959 patients assessed by endoscopy was 0.54% (38 out of 6959 subjects). Sex distribution was 26 men (68.4%) and 12 women (31.5%). Mean age was 53 years (age range 21-85 years). Stomach, specifically the antrum (47.36%), was the most common site for xanthelasmas, followed by the esophagus (18.42%) and duodenum (18.42%). The majority of patients with xanthelasma had no associated GI pathology, while 21% had gastritis. Conclusion: Gastric xanthelasmas are more common than esophageal or duodenal xanthelasmas. Esophageal xanthomas are not as rare as is considered in the literature. Xanthomas were found to co-exist with gastritis.