Left: Pale mucosal elevation found in the gastric antrum in a 76 year-old woman undergoing endoscopy for evaluation of bleeding. Biopsies revealed moderate chronic inflammation and increased numbers of foamy, lipid-laden histiocytes, consistent with a diagnosis of gastric xanthelasma (xanthoma). No Helicobacter pylori were seen.

Center: Yellow mucosal plaque seen in the gastric antrum of a 53 year-old woman with acid-peptic symptoms that failed to respond to therapy. Biopsies revealed moderate to severe acute and chronic inflammation with numerous Helicobacter pylori, and collections of foamy macrophages underneath the surface epithelium, consistent with xanthelasma (xanthoma) of the stomach.

Right: Small polypoid xanthoma, an incidental finding at the time of percutaneous endoscopic gastrostomy placement in an 89 year-old woman with inability to swallow.