Answer: Gastric xanthoma, CD68 and pan-CK

Gastric xanthoma is a benign lesion composed of foamy macrophages (xanthoma cells) accumulating in the lamina propria. It is a non-neoplastic lesion and usually an incidental finding. In endoscopy, small yellow white nodules or plaques are seen.

Usually, other concurrent mucosal pathology such as Helicobacter pylori gastritis, intestinal metaplasia, early gastric cancer, etc. exist so one should carefully examine the background mucosa to rule out other pathologic findings. It has a male predominance (3:1) with a mean age of 60. In the GI tract, the most common site is the stomach (specially antrum). Cutaneous xanthoma and xanthelasma are associated with lipid metabolism disorder but the same link is not as clear for gastric xanthomas. One hypothesis suggests it might be caused by previous injury or inflammation and phagocytosis of lipid rich material by macrophages.