Primary Histiocytosis X of the Stomach Diagnosed with Biopsy, Report of a Case Masanori Shiratsuka 1,2 , Mitsuya Iwafuchi 3 , Hidenobu Watanabe 3 , Toshimitsu Suzuki 3 , Noriko Ishihara 3 2Shiratsuka Clinic 3The First Department of Pathology, Niigata University School of Medicine pp.1235-1243
Published Date 1985/11/25
DOI https://doi.org/10.11477/mf.1403109709
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 A 49 year-old Japanese woman, with no particular complaints, was referred to our hospital on January 1983. Physical examination and study of the blood, urine and feces showed no remarkable changes. X-ray and endoscopic examination revealed innumerable elevated lesions throughout the stomach. The biopsy specimens proved the elevated lesions to be formed by diffuse proliferation of histiocytoid cells in the lamina propria mucosae. They had abundant, slightly eosinophilic cytoplasm and eccentric, ovoid to irregularly indented, vesicular nuclei with small nucleoli. Many histiocytoid cells contained S-100 protein diffusely in their cytoplasm. Lysozyme and α1 alantitrypsin were negative in most of them except for a few cells showing faintly positive reaction. No histiocytoid cells showed CEA or nonspecific antigen cross-reacting with carcinoembryonic antigen. Ultrastructurally some of them contained a single or clusters of Birbeck granules in their cytoplasm mainly at the periphery. Systemic examination by x-ray, endoscopy and computed tomography revealed no abnormality outside the stomach. Therefore the present case was diagnosed as primary histiocytosis X of the stomach.

 The patient has been followed up without therapy. Re-examinations by x-ray, endoscopy and biopsy showed no significant changes macroscopically and microscopically. In June 1984, 18 months after the diagnosis, she has continued to be well without complaints.

 Only four cases, including ours, are reported as primary histiocytosis X of the stomach. This is the fiirst case that extended throughout the stomach in fashion of polyposis and that was diagnosed with biopsy.

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