Background: Lanthanum carbonate is widely used as a phosphate binder in patients undergoing hemodialysis and is considered safe. However, lanthanum deposition in gastrointestinal mucosa has been increasingly reported.
Case: A man in his seventies undergoing long-term hemodialysis for diabetic nephropathy had been treated with lanthanum carbonate for approximately 13 years. The patient had previously undergone distal gastrectomy for advanced gastric cancer. Follow-up esophagogastroduodenoscopy revealed multiple fine, whitish granular lesions extending from the lesser curvature to the posterior wall of the upper gastric body. Histopathological examination revealed macrophages containing fine brownish granular or crystalline material in the lamina propria. Immunohistochemical staining revealed CD68-positive macrophage aggregation, leading to the diagnosis of gastric lanthanum deposition.
Conclusion: Granular whitish gastric mucosal lesions should be suspected in patients undergoing long-term lanthanum carbonate therapy.
