Question

Which condition may feature fat-laden histiocytes in the gastric mucosa?

• A. Signet ring cell carcinoma
• B. Erosive gastritis
• C. Post-gastrectomy status
• D. Lymphoma

Hint:

Gastric xanthoma (fat-laden histiocytes) is tied to chronic bile reflux, and shows up most often in the gastric remnant after gastrectomy.

Answer 1

The Correct Option is C

Step 1: Identify the finding.
Fat-laden histiocytes sitting in the gastric mucosa are called gastric xanthoma, also known as xanthelasma of the stomach. Under the microscope they look like clusters of foamy macrophages that have taken up lipid.

Step 2: Recall why these cells form.
The lipid comes from damaged epithelial cells. When the mucosa is hurt again and again, macrophages move in to clear the debris and end up loaded with fat. This kind of injury is strongly tied to long standing bile reflux into the stomach.

Step 3: Link the finding to the clinical setting.
After a gastrectomy, the normal pylorus that stops bile from moving backward is gone or altered. Bile keeps washing over the remaining gastric mucosa, so gastric xanthomas turn up far more often in the gastric remnant of post-gastrectomy patients than in a normal stomach.

Step 4: Rule out the other options.
Signet ring carcinoma cells are filled with mucin, not fat, and the nucleus gets pushed to one side, so this is a different cell picture. Erosive gastritis shows mucosal erosions with acute inflammation, not fat filled macrophages as its defining feature. Lymphoma shows a monotonous infiltrate of lymphoid cells, again not histiocytes packed with lipid.

Step 5: Final answer.
The condition linked with fat-laden histiocytes in the gastric mucosa is
\[ \boxed{\text{Post-gastrectomy status}} \]