抄録
Meterial and methods: During a period of 7 years, 4706 gastroscopic examinations were performed by the author at the Institute of Gastroenterology, Tokyo Women's Medical College. Among them, 413 patients were diagnosed as gastric xanthoma (8.7%). This is ao report of the endoscopic characteristics and the studies of associated gastritis and further investigation by endoscopic dyeing with methylenn blue and congo red, scanning electron microscopy, histochemical analysis of gastric xanthoma in addition to histopathological examination. Endoscopic examination: The incidence of gastric xanthoma was higher in female than in male in each age group: The incidence increased when they got loder. Many patients had only single xanthoma in the stomach. No correlation between gastric xanthoma and serum cholesterol was found. The gastric xanthoma was most frequently seen at the prepyloric region. It represented 38% of the cases. About 15% of cases were located at gastric body and gatsric angle. The shape of xanthoma varied; some are plateau-like elevation, some are flat. The surface of the xanthoma were similar to the gastric areola. The relation of gastric gland and xanthoma was investigated by the method of endoscopic dyeing with Congo red. All of the gastric xanthomas were located within the territory of the pyloric glands. It indicates close association of xanthoma with atrophic gastritis. The coexistence of intestinal metaplsia in gastric xanthoma was investigated by endoscopic dyeing with Methylene blue and histoachemical examination. Methylene blue was present around the epitelial cells in about 64%, while, positive staining by alkaline phosphatase was noted up to 80%. Scanning electron microscopic observation: The tissue taken during biopsy was investigated by scanning electron microscope The xanthoma appeared countless thick microvilli under scanning electronmicroscopy. Each of the microvillus represented opening of paneth cells and absorpt ive cells. Histop athologica observation: Intestinal metaplasia was present on the surface of gastric xanthoma in 44%. Biochemical analysis and biochemical examination: The lipid content was analysed by gas chromatography in xanthomas. Freecholesterol and triglycerides were all present, but all cholesterol was not esterified.
