Stomach
Other nonneoplastic
Lanthanum carbonate deposition


Topic Completed: 24 February 2021

Minor changes: 25 February 2021

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PubMed Search: lanthanum carbonate deposition

Raul S. Gonzalez, M.D.
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Cite this page: Gonzalez RS. Lanthanum carbonate deposition. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stomachLCD.html. Accessed May 15th, 2021.
Definition / general
  • Lanthanum carbonate is an oral phosphate binder used to treat hyperphosphatemia in patients with end stage renal disease
  • Recent reports have indicated that the medication can deposit throughout the gastrointestinal tract mucosa, most commonly in the stomach but also in the small intestine and colon (Am J Surg Pathol 2015;39:767, Int J Surg Pathol 2016;24:89)
Essential features
  • Lanthanum may become embedded in the mucosa following digestion by gastric acid; deposition may be detected years after cessation of therapy (Pathol Int 2017;67:389)
  • Lanthanum deposition can be detected radiographically but is most often observed microscopically on biopsy tissue
Epidemiology
  • Patients with end stage renal disease
Gross description
  • Appears as aggregates of brown purple amorphous material in the mucosa, engulfed by epithelioid histiocytes
  • Overlying mucosa may be intact or eroded
  • Identity of the material can be confirmed by energy dispersive Xray spectrometry, if necessary
Microscopic (histologic) images

Case #442

Lanthanum carbonate in stomach

Von Kossa

Negative stains
Sample pathology report
  • Stomach, fundus, biopsy:
    • Stomach mucosal with reactive change and focal lanthanum carbonate deposition (see comment)
    • Comment: The patient’s history of end stage renal disease and use of oral lanthanum carbonate deposition is noted. The deposited material is negative on von Kossa special stain.
Differential diagnosis
Board review style question #1
A 35 year old man with no history of renal failure undergoes upper endoscopy and colonoscopy for abdominal pain. Crystalline material is observed deposited in his gastric mucosa. What is the most likely identity of this material?

  1. Calcium
  2. Iron
  3. Kayexalate
  4. Lanthanum
  5. OsmoPrep
Board review style answer #1
E. OsmoPrep, used to prepare the bowel for endoscopy

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