Colon
Other nonneoplastic
Xanthoma


Topic Completed: 16 February 2021

Minor changes: 17 February 2021

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PubMed Search: Colonic xanthoma

Raul S. Gonzalez, M.D.
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Cite this page: Gonzalez RS. Xanthoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colonxanthoma.html. Accessed April 19th, 2021.
Definition / general
  • Localized mass forming collection of lipid bearing histiocytes
Essential features
  • Rare but typically incidental and benign polypoid collection of histiocytes
Terminology
  • Also called xanthomatous polyp, xanthogranulomatous inflammation, xanthelasma
Epidemiology
  • Very rare in colon - stomach is most common gastrointestinal site
Sites
  • Colonic examples almost always rectosigmoid
Etiology
  • May be due to prior injury
Clinical features
  • Colon polyp
  • May clinically resemble carcinoma
  • May cause intestinal obstruction if more extensive and involving deeper layers
Case reports
  • 38 year old woman with xanthogranulomatous inflammation presenting as a submucosal mass of the sigmoid colon (Pathol Int 2005;55:440)
  • 68 year old man with xanthoma disseminatum with large plaques confined to the back, pulmonary involvement and multiple intestinal xanthomas (Dermatology 2004;208:164)
Microscopic (histologic) description
  • Collection of foamy cells without mucin, typically limited to lamina propria
  • Associated with surface hyperplastic change (APMIS 2004;112:3)
Microscopic (histologic) images

Contributed by Raul S. Gonzalez, M.D. and Jian-Hua Qiao, M.D.

Xanthoma

Prominent clusters of foamy histiocytes in colon polyp

Positive stains
Negative stains
Electron microscopy description
  • Electron dense globules
Sample pathology report
  • Descending colon, polypectomy:
    • Xanthoma
Differential diagnosis
Board review style question #1

    Xanthomas of the colon are positive for which of the following stains?

  1. CD1a
  2. CD68
  3. S100
  4. Mucicarmine
Board review style answer #1
B. CD68

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