Nadir Lokalizasyonlu Gastrik Ksantom: İki Olgu Sunumu
Ksantomlar, üst gastrointestinal sistem endoskopisi sırasında nadir görülen insidental lezyonlardır. Gastrointestinal traktın bütün alanlarında görülebilir ama en sık midede, sıklıkla da antrum ve pilorik bölgededir. Literatürde kardia ve fundusta yerleşim gösteren az sayıda rapor mevcuttur. Gastrik ksantomlar soluk sarı renkte, tek veya çok sayıda, 1-2 mm çapında, mukozal nodül veya plaklar oluşturur. Endoskopi esnasında maligniteyi taklit edebilir ve deneyimsiz klinisyenlerce malignite ile karıştırılabilir. Histopatolojik olarak berrak hücreli karsinoid tümöre ve taşlı yüzük hücreli adenokarsinoma benzeyebilir. Midede daha nadir lokalizasyon alanı olan kardiya ve fundusta yerleşim gösteren iki gastrik ksantom olgusu sunuyoruz.
Gastric Xanthoma in Rare Localisation: Report of Two Cases
Xanthomas are rare and incidental lesions usually seen during upper gastrointestinal system endoscopy. They can be seen in all parts of gastrointestinal tractus but they are commonly found in stomach, especially at the antrum and piloric region. There are few reports in the literature which are about cardia and fundus localization. Gastric xanthomas are in pale yellow in colour and form multiple mucosal nodules or plaques in 1 to 2 mm in diameter. They may mimic malignancy during endoscopy and may be confused with malignancy by inexperienced clinicians. They may histopathologically resemble clear cell carcinoid tumors and signet ring cell adenocarcinomas. We are presenting two gastric xanthoma cases at rare localisations such as cardia and fundus.
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- 1. Gencosmanoglu R, Sen-Oran E, Kurtkayayapicier O, Tozun N. Xanthelasmas of upper gastrointestinal tract. J Gastroenterol 2004; 39: 215-9.
- 2. Ertaş Ö, Türkeş Ş, Erdenen F, Bahadır F, Bektaş H, Huten ON. Gastrik ksantelazmalı olgu sunumu. İstanbul Tıp Dergisi 2007; 1: 39-41.
- 3. Coates AG, Nostrant TT, Wilson JA, Dobbins WO 3rd, Agha FP. Gastric xanthomatosis and cholestasis. A causal relationship. Dig Dis Sci 1986; 31: 925-8.
- 4. Sekikawa A, Fukui H, Maruo T, TsumuraT, Okabe Y, Osaki Y. Gastric xanthelasma may be a warning sign for he presence of early gastric cancer. J Gastroenterol Hepatol 2014; 29: 951-6.
- 5. Kitamura S, Muguruma N, Okamoto K et al. Clinicopathological assessment of gastric xanthoma as potential predictive marker of gastric cancer. Digestion 2017; 96: 199-206.
- 6. Shibukawa N, Ouchi S, Wakamatsu S, Wakahara Y, Kaneko A. Gastric xanthoma is a predictive marker for early gastric cancer detected after helicobacter pylori eradication. Intern Med 2019; 58: 779-84.
- 7. Andrejic BM, Bozanic SV, Solajic NS, Djolai MA, Levakov AM. Xanthomas of the stomach: a report of two case. Bosn J Basic Med Sci 2012; 12: 127- 9.
- 8. Gürsoy Ş, Yurci A, Torun E et al. An uncommon lesion: Gastric Xanthelasma. Turk J Gastroenterol 2005; 16: 167-70.
- 9. Devojee M, Rajeshwari G, JaganMohanRao K, Akarsh MP. Xanthelasmas of upper gastrointestinal tract: A report case of four cases. JEBMH 2004; 18: 2781-5.
- 10. Dizdar OS, Eminler AT, Ayyıldız T, Kahyaoğlu Z, Dolar E. Gastric xanthalesmas: Report of five cases and review of the literature. J Exp Clin Med 2015; 32: 91-5.
- 11. Muraoka A, Suehiro I, Fuji M et al. Type IIa early gastric cancer with proliferation of xanthoma cells. J Gastroenterol 1988; 33: 326-9.
- 12. Ovideo J, Swan N, Farraye FA. Gastrik Xanthomas. Am J Gastroenterol 2001; 96: 3216-8.
- 13. Chen Y, He XJ, Zhou MJ, Li YM. Gastric xanthelesma and metabolic disorders: A large retrospective study among Chinese population. World J Gastroenterol 2017; 23: 779-84.
- 14. Köksal AŞ, Suna N, Kalkan İH et al. Is Gastric Xanthelasma an Alarming Endoscopic Marker for Advanced Atrophic Gastritis and Intestinal Metaplasia? Dig Dis Sci 2016; 61: 2949-55.
- 15. Hori S, Tsutsumi Y. Helicobacter pylori infection in gastric xanthomas: immunohistochemical analysis of 145 lesions. Pathol Int 1996; 46: 589-93.
- 16. Montgomery EA, Voltaggio L. Stomach. In: Biopsy Interpretation of Gastrointestinal Tract Mucosa Volume 2: Neoplastic. 2. Baskı, Philadelphia: Wolters-Kluwer, Lippincott Williams&Wilkins 2012; 62-125.