Gencosmanoglu Rasim, Sen-Oran Ebru, Kurtkaya-Yapicier Ozlem, Tozun Nurdan
Unit of Surgery, Marmara University Institute of Gastroenterology, Basibuyuk, Maltepe, Istanbul, Turkey.
J Gastroenterol. 2004;39(3):215-9. doi: 10.1007/s00535-003-1288-3.
Gastric xanthelasma is a benign and uncommon lesion with a variably reported frequency, while esophageal and duodenal xanthelasmas are quite rare.
Seventeen patients who had the diagnosis of xanthelasma in the upper gastrointestinal tract were analyzed retrospectively with respect to their demographic, clinical, endoscopic, and histopathologic features. All lesions suspected as xanthelasma were totally removed by either hot biopsy forceps or a snare with the technique of endoscopic mucosal resection.
The incidence of upper gastrointestinal xanthelasmas in 7320 patients who had upper gastro-intestinal endoscopy was 0.23%. There were 9 (53%) men and 8 (47%) women, with a median age of 50 years (range, 24-80 years). The most common location of xanthelasmas was the stomach (76%), followed by the esophagus (12%) and duodenum (12%). All lesions were observed as yellow-white colored plaques at endoscopy. Multiple xanthelasmas were detected in 4 patients (24%); in the duodenum in 2, esophagus in 1, and stomach in 1. One patient had xanthelasma within a gastric hyperplastic polyp. The size of the lesion was less than 5 mm in diameter in 14 (82%) patients and between 5 and 10 mm in diameter in 3 (18%). Thirteen (76%) patients had moderate to severe atrophic gastritis, while the remainder had normal gastric mucosa. CONCLUSIONS. Xanthelasmas of the upper gastrointestinal tract were mostly located in the stomach in the present series, which includes the second and third reported cases of duodenal xanthelasma, the second case of xanthelasma developed within a hyperplastic gastric polyp, and the fourth and the fifth cases of esophageal xanthelasma.
胃黄斑瘤是一种良性且不常见的病变，其报道的发病率各不相同，而食管和十二指肠黄斑瘤则极为罕见。
对17例在上消化道被诊断为黄斑瘤的患者的人口统计学、临床、内镜及组织病理学特征进行回顾性分析。所有疑似黄斑瘤的病变均通过热活检钳或圈套器采用内镜黏膜切除术技术完全切除。
在7320例行上消化道内镜检查的患者中，上消化道黄斑瘤的发病率为0.23%。男性9例（53%），女性8例（47%），中位年龄为50岁（范围24 - 80岁）。黄斑瘤最常见的部位是胃（76%），其次是食管（12%）和十二指肠（12%）。在内镜检查中，所有病变均表现为黄白色斑块。4例患者（24%）检测到多发黄斑瘤；2例在十二指肠，1例在食管，1例在胃。1例患者的胃增生性息肉内有黄斑瘤。14例（82%）患者病变直径小于5mm，3例（18%）患者病变直径在5至10mm之间。13例（76%）患者有中度至重度萎缩性胃炎，其余患者胃黏膜正常。结论：在本系列研究中，上消化道黄斑瘤大多位于胃，其中包括第二例和第三例报道的十二指肠黄斑瘤、第二例胃增生性息肉内发生的黄斑瘤以及第四例和第五例食管黄斑瘤。
