Xanthogranulomatous gastritis of the remnant stomach mimicking a malignant tumor: A case report

Okamura,Akihiko; Takahashi,Tsunehiro; Saikawa,Yoshiro; Nakadai,Jumpei; Ono,Taiki; Nakamura,Rieko; Wada,Norihito; Kawakubo,Hirofumi; Takeuchi,Hiroya; Emoto,Katsura; Sasaki,Aya; Kameyama,Kaori; Kitagawa,Yuko

doi:10.3892/ol.2015.4054

Xanthogranulomatous gastritis of the remnant stomach mimicking a malignant tumor: A case report

Authors:
- Akihiko Okamura
- Tsunehiro Takahashi
- Yoshiro Saikawa
- Jumpei Nakadai
- Taiki Ono
- Rieko Nakamura
- Norihito Wada
- Hirofumi Kawakubo
- Hiroya Takeuchi
- Katsura Emoto
- Aya Sasaki
- Kaori Kameyama
- Yuko Kitagawa
View Affiliations

Affiliations: Department of Surgery, School of Medicine, Keio University, Tokyo 160‑8582, Japan, Division of Diagnostic Pathology, School of Medicine, Keio University, Tokyo 160‑8582, Japan
Published online on: December 24, 2015 https://doi.org/10.3892/ol.2015.4054
Pages: 1453-1456

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Xanthogranulomas are known to develop in the gallbladder and kidney. Xanthogranuloma of the stomach is a rare disease, and to the best of our knowledge, only a few cases have been reported to date. The present patient was a 64‑year‑old man who underwent a wide resection of the stomach following a Billroth‑I reconstruction for a gastric ulcer ~40 years prior to the current presentation. Due to tarry stools, a gastrointestinal endoscopy was performed, leading to identification of an ulcerated gastric lesion located at the previous suture line at the lesser curvature of the remnant stomach. This lesion was elevated, appearing to indicate a submucosal tumor. Positron emission tomography revealed uptake of fluorodeoxyglucose radiotracer by the tumor. Although not indicated by the biopsy specimens, a malignant tumor of the remnant stomach was suspected, in the form of a malignant gastrointestinal tumor or remnant gastric cancer. Curative resection of the tumor was successfully performed. Histological examination of the resected specimens revealed xanthogranulomatous inflammation consisting of foamy histiocytes and plasma cells, however, no cancer cells were observed. The tumor was diagnosed as xanthogranulomatous gastritis that mimicked a malignant tumor of the remnant stomach. The present study therefore indicates that inflammatory tumors should be considered in the differential diagnosis of malignant tumors.

View Figures

View References

1	Benbow EW: Xanthogranulomatous cholecystitis. Br J Surg. 77:255–256. 1990. View Article : Google Scholar : PubMed/NCBI
2	Korkes F, Favoretto RL, Bróglio M, Silva CA, Castro MG and Perez MD: Xanthogranulomatous pyelonephritis: Clinical experience with 41 cases. Urology. 71:178–180. 2008. View Article : Google Scholar : PubMed/NCBI
3	Oh YH, Seong SS, Jang KS, Chung YW, Paik CH, Park YW and Han DS: Xanthogranulomatous inflammation presenting as a submucosal mass of the sigmoid colon. Pathol Int. 55:440–444. 2005. View Article : Google Scholar : PubMed/NCBI
4	Nishimura M, Nishihira T, Hirose T, Ishikawa Y, Yamaoka R, Inoue H and Tatsuta M: Xanthogranulomatous pancreatitis mimicking a malignant cystic tumor of the pancreas: Report of a case. Surg Today. 41:1310–1313. 2011. View Article : Google Scholar : PubMed/NCBI
5	Russack V and Lammers RJ: Xanthogranulomatous endometritis. Report of six cases and a proposed mechanism of development. Arch Pathol Lab Med. 114:929–932. 1990.PubMed/NCBI
6	Zafisaona G and Kermarec J: Inflammatory fibrous histiocytoma of the stomach. Apropos of a case of xanthogranuloma? Arch Anat Cytol Pathol. 35:149–153. 1987.(In French). PubMed/NCBI
7	Kubosawa H, Yano K, Oda K, Shiobara M, Ando K, Nunomura M and Sarashina H: Xanthogranulomatous gastritis with pseudosarcomatous changes. Pathol Int. 57:291–295. 2007. View Article : Google Scholar : PubMed/NCBI
8	Lai HY, Chen JH, Chen CK, Chen YF, Ho YJ, Yang MD and Shen WC: Xanthogranulomatous pseudotumor of stomach induced by perforated peptic ulcer mimicking a stromal tumor. Eur Radiol. 16:2371–2372. 2006. View Article : Google Scholar : PubMed/NCBI
9	Lespi PJ: Gastric xanthogranuloma (inflammatory malignant fibrohistiocytoma). Case report and literature review. Acta Gastroenterol Latinoam. 28:309–310. 1998.(In Spanish). PubMed/NCBI
10	Parsons MA: Xanthogranulomatous gastritis: An entity or a secondary phenomenon? J Clin Pathol. 46:580–581. 1993. View Article : Google Scholar : PubMed/NCBI
11	Guarino M, Reale D, Micoli G, Tricomi P and Cristofori E: Xanthogranulomatous gastritis: Association with xanthogranulomatous cholecystitis. J Clin Pathol. 46:88–90. 1993. View Article : Google Scholar : PubMed/NCBI
12	Zhang L, Huang X and Li J: Xanthogranuloma of the stomach: A case report. Eur J Surg Oncol. 18:293–295. 1992.PubMed/NCBI
13	Tsukada T, Nakano T, Miyata T, Sasaki S and Higashi K: Xanthogranulomatous gastritis mimicking malignant GIST on F-18 FDG PET. Ann Nucl Med. 26:752–756. 2012. View Article : Google Scholar : PubMed/NCBI
14	Kinoshita H, Yamaguchi S, Sakata Y, Arii K, Mori K and Kodama R: A rare case of xanthogranuloma of the stomach masquerading as an advanced stage tumor. World J Surg Oncol. 9:672011. View Article : Google Scholar : PubMed/NCBI
15	Banerjee S, Shah S, Chandran BS, Pulimood A and Mathew G: Chronic perforation in isolated xanthogranulomatous gastritis. Trop Gastroenterol. 31:45–47. 2010.PubMed/NCBI
16	Aikawa M, Ishii T, Nonaka K, Nakao M, Ishikawa K, Arai S, Kita H, Miyazawa M, Koyama I, Motosugi U and Ban S: A case of gastric xanthogranuloma associated with early gastric cancer. Nihon Shokakibyo Gakkai Zasshi. 106:1610–1615. 2009.(In Japanese). PubMed/NCBI
17	Japanese Gastric Cancer Association: Japanese gastric cancer treatment guidelines (ver. 3). Gastric Cancer. 14:113–123. 2011.PubMed/NCBI
18	Goodman ZD and Ishak KG: Xanthogranulomatous cholecystitis. Am J Surg Pathol. 5:653–659. 1981. View Article : Google Scholar : PubMed/NCBI
19	Czernin J, Allen-Auerbach M and Schelbert HR: Improvements in cancer staging with PET/CT: Literature-based evidence as of September 2006. J Nucl Med. 48(Suppl 1): S78–S88. 2007.
20	Makino I, Yamaguchi T, Sato N, Yasui T and Kita I: Xanthogranulomatous cholecystitis mimicking gallbladder carcinoma with a false-positive result on fluorodeoxyglucose PET. World J Gastroenterol. 15:3691–3693. 2009. View Article : Google Scholar : PubMed/NCBI