Sporadic Minute Pharyngeal Xanthomas Detected Incidentally During Esophagogastroduodenoscopy: A Case Series

Pharyngeal xanthomas are considered rare, and no reports have described their endoscopic appearance under magnifying or image-enhanced endoscopy. We report three cases of asymptomatic sporadic pharyngeal xanthoma that were detected incidentally during routine esophagogastroduodenoscopy. All the patients were men and had a solitary lesion of about 1 mm in size. Two of the lesions were located in the oropharynx, while one was in the hypopharynx. Non-magnifying endoscopy showed yellowish lesions, and magnifying endoscopy showed an aggregation of minute yellowish nodules with tortuous microvessels on their surface. Histopathological examination revealed foam cells filling the intraepithelial papillae. The foam cells were strongly immunopositive for cluster of differentiation (CD) 68. Immunohistochemical staining for CD34 showed intrapapillary capillaries around the foam cells. This characteristic magnifying endoscopic appearance corresponded to the histopathological findings of pharyngeal xanthomas. The present cases reveal the relationship between the endoscopic appearance and histopathological findings of pharyngeal xanthomas.