Gastric xanthoma

At low power (upper panel), the lamina propria of the surface/foveolar zone is expanded by a cellular infiltrate. The epithelium is normal. At high power (lower panel), the infiltrate consists of cells with small central benign nuclei and copious faintly basophilic cytoplasm. On immunostaining, these cells are CD68-positive, thus defining them as macrophages. The cytoplasm contains phagocytized lipid material. The appearance is typical of a gastric xanthoma. Similar endoscopic findings are seen in granular cell tumors and muciphages. Gastric xanthomas are sessile, yellow nodules, usually diminutive (<5 mm) in size, confined to the mucosa. This represents accumulation of lipid in macrophages. Gastric xanthomas have no malignant potential.