Lanthanum deposition corresponds to white lesions in the stomach

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: Although lanthanum deposition in the stomach has been most frequently reported to occur as white lesions, no study has investigated whether the white lesions observed during esophagogastroduodenoscopy are truly lanthanum-related. Here, we retrospectively investigated the amount of lanthanum in endoscopic biopsy specimens. Methods: We reviewed four patients showing gastric white spots or annular whitish mucosa in the gastric white lesions (Bw) and peripheral mucosa where the white substance was not endoscopically observed (Bp) during biopsy. We also reviewed three patients with diffuse whitish mucosa and three patients with no whitish lesions. We performed scanning electron microscopy and energy dispersive X-ray spectrometry to quantify the lanthanum elements (wt%) in the biopsy specimens. Results: The amount of lanthanum in the Bw ranged from 0.15–0.31 wt%, whereas that of Bp was 0.00–0.13 wt%. The difference was statistically significant (P < 0.05). The amount of lanthanum in the Bw, endoscopically presented with white spots or annular whitish mucosa, was significantly higher than that of no whitish lesions (0.05–0.14 wt%, P < 0.05). The amount of lanthanum was also higher in the diffuse whitish mucosa (0.21–0.23 wt%) compared with no whitish lesions (P < 0.01). Conclusions: This study is the first to reveal that pathological lanthanum deposition corresponds to the endoscopically observed white lesions in the gastric mucosa. Therefore, during esophagogastroduodenoscopy, physicians should pay attention to possible presence of white lesions in patients treated with oral lanthanum carbonate to ensure prompt identification of associated issues.

Original languageEnglish
Pages (from-to)934-939
Number of pages6
JournalPathology Research and Practice
Volume214
Issue number7
DOIs
Publication statusPublished - Jul 1 2018

Fingerprint

Lanthanum
Stomach
Mucous Membrane
Digestive System Endoscopy
Dental Caries
Gastric Mucosa
Biopsy
X-Ray Emission Spectrometry
Electron Scanning Microscopy
Physicians

Keywords

  • Esophagogastroduodenoscopy
  • Hyperphosphatemia
  • Lanthanum carbonate
  • Scanning electron microscopy analysis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Cell Biology

Cite this

Lanthanum deposition corresponds to white lesions in the stomach. / Iwamuro, Masaya; Urata, Haruo; Tanaka, Takehiro; Kawano, Seiji; Kawahara, Yoshiro; Kimoto, Katsuhiko; Okada, Hiroyuki.

In: Pathology Research and Practice, Vol. 214, No. 7, 01.07.2018, p. 934-939.

Research output: Contribution to journalArticle

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title = "Lanthanum deposition corresponds to white lesions in the stomach",
abstract = "Objective: Although lanthanum deposition in the stomach has been most frequently reported to occur as white lesions, no study has investigated whether the white lesions observed during esophagogastroduodenoscopy are truly lanthanum-related. Here, we retrospectively investigated the amount of lanthanum in endoscopic biopsy specimens. Methods: We reviewed four patients showing gastric white spots or annular whitish mucosa in the gastric white lesions (Bw) and peripheral mucosa where the white substance was not endoscopically observed (Bp) during biopsy. We also reviewed three patients with diffuse whitish mucosa and three patients with no whitish lesions. We performed scanning electron microscopy and energy dispersive X-ray spectrometry to quantify the lanthanum elements (wt{\%}) in the biopsy specimens. Results: The amount of lanthanum in the Bw ranged from 0.15–0.31 wt{\%}, whereas that of Bp was 0.00–0.13 wt{\%}. The difference was statistically significant (P < 0.05). The amount of lanthanum in the Bw, endoscopically presented with white spots or annular whitish mucosa, was significantly higher than that of no whitish lesions (0.05–0.14 wt{\%}, P < 0.05). The amount of lanthanum was also higher in the diffuse whitish mucosa (0.21–0.23 wt{\%}) compared with no whitish lesions (P < 0.01). Conclusions: This study is the first to reveal that pathological lanthanum deposition corresponds to the endoscopically observed white lesions in the gastric mucosa. Therefore, during esophagogastroduodenoscopy, physicians should pay attention to possible presence of white lesions in patients treated with oral lanthanum carbonate to ensure prompt identification of associated issues.",
keywords = "Esophagogastroduodenoscopy, Hyperphosphatemia, Lanthanum carbonate, Scanning electron microscopy analysis",
author = "Masaya Iwamuro and Haruo Urata and Takehiro Tanaka and Seiji Kawano and Yoshiro Kawahara and Katsuhiko Kimoto and Hiroyuki Okada",
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T1 - Lanthanum deposition corresponds to white lesions in the stomach

AU - Iwamuro, Masaya

AU - Urata, Haruo

AU - Tanaka, Takehiro

AU - Kawano, Seiji

AU - Kawahara, Yoshiro

AU - Kimoto, Katsuhiko

AU - Okada, Hiroyuki

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Objective: Although lanthanum deposition in the stomach has been most frequently reported to occur as white lesions, no study has investigated whether the white lesions observed during esophagogastroduodenoscopy are truly lanthanum-related. Here, we retrospectively investigated the amount of lanthanum in endoscopic biopsy specimens. Methods: We reviewed four patients showing gastric white spots or annular whitish mucosa in the gastric white lesions (Bw) and peripheral mucosa where the white substance was not endoscopically observed (Bp) during biopsy. We also reviewed three patients with diffuse whitish mucosa and three patients with no whitish lesions. We performed scanning electron microscopy and energy dispersive X-ray spectrometry to quantify the lanthanum elements (wt%) in the biopsy specimens. Results: The amount of lanthanum in the Bw ranged from 0.15–0.31 wt%, whereas that of Bp was 0.00–0.13 wt%. The difference was statistically significant (P < 0.05). The amount of lanthanum in the Bw, endoscopically presented with white spots or annular whitish mucosa, was significantly higher than that of no whitish lesions (0.05–0.14 wt%, P < 0.05). The amount of lanthanum was also higher in the diffuse whitish mucosa (0.21–0.23 wt%) compared with no whitish lesions (P < 0.01). Conclusions: This study is the first to reveal that pathological lanthanum deposition corresponds to the endoscopically observed white lesions in the gastric mucosa. Therefore, during esophagogastroduodenoscopy, physicians should pay attention to possible presence of white lesions in patients treated with oral lanthanum carbonate to ensure prompt identification of associated issues.

AB - Objective: Although lanthanum deposition in the stomach has been most frequently reported to occur as white lesions, no study has investigated whether the white lesions observed during esophagogastroduodenoscopy are truly lanthanum-related. Here, we retrospectively investigated the amount of lanthanum in endoscopic biopsy specimens. Methods: We reviewed four patients showing gastric white spots or annular whitish mucosa in the gastric white lesions (Bw) and peripheral mucosa where the white substance was not endoscopically observed (Bp) during biopsy. We also reviewed three patients with diffuse whitish mucosa and three patients with no whitish lesions. We performed scanning electron microscopy and energy dispersive X-ray spectrometry to quantify the lanthanum elements (wt%) in the biopsy specimens. Results: The amount of lanthanum in the Bw ranged from 0.15–0.31 wt%, whereas that of Bp was 0.00–0.13 wt%. The difference was statistically significant (P < 0.05). The amount of lanthanum in the Bw, endoscopically presented with white spots or annular whitish mucosa, was significantly higher than that of no whitish lesions (0.05–0.14 wt%, P < 0.05). The amount of lanthanum was also higher in the diffuse whitish mucosa (0.21–0.23 wt%) compared with no whitish lesions (P < 0.01). Conclusions: This study is the first to reveal that pathological lanthanum deposition corresponds to the endoscopically observed white lesions in the gastric mucosa. Therefore, during esophagogastroduodenoscopy, physicians should pay attention to possible presence of white lesions in patients treated with oral lanthanum carbonate to ensure prompt identification of associated issues.

KW - Esophagogastroduodenoscopy

KW - Hyperphosphatemia

KW - Lanthanum carbonate

KW - Scanning electron microscopy analysis

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