Pattern of gastric lanthanum deposition based on the presence or absence of mucosal atrophy

Aim: This study aimed to investigate the relationship between the pattern of gastric lanthanum deposition and gastric mucosal atrophy. Methods: We retrospectively reviewed 4 patients with gastric lanthanum deposition who tested negative for Helicobacter pylori infection (non-atrophy group) and 10 patients with gastric lanthanum deposition with gastric atrophy (atrophy group). The endoscopic features of gastric lanthanum deposition were retrospectively analyzed in both groups. Results: Although gastric lanthanum deposition appears as white lesions, this presentation was not observed in 1 of the 4 patients in the non-atrophy group. The remaining 3 patients (75%) had diffuse white lesions in the gastric body that were predominantly distributed in the posterior wall and lesser curvature. In the atrophy group, white lesions were found in 9 of the 10 cases. In the areas with atrophic mucosa, white lesions were most frequently found in the gastric antrum (n = 5) and angle (n = 5). The white lesions appeared in an annular and/or granular pattern. White lesions were also found in the gastric body with mucosal atrophy and presented in an annular pattern (n = 1) or as diffuse whitish lesions (n = 1). Based on these findings, we speculate that in patients without gastric mucosal atrophy, gastric lanthanum deposition appears as diffuse white lesions in the posterior wall and lesser curvature of the gastric body. In the gastric mucosa with atrophy, lanthanum-related lesions likely appear as annular or granular white lesions. Moreover, these white lesions are probably more frequently observed in the gastric antrum and angle since atrophy begins at the lower part of the stomach. Conclusions: These findings suggest that the localization and macroscopic findings of gastric lanthanum deposition differ depending on the presence or absence of gastric atrophy.