title: Extensive lanthanum deposition in the gastric mucosa: the first histopathological report.
abstract: Lanthanum carbonate is one of the new phosphate binders used for the treatment of hyperphosphatemia in patients with chronic kidney disease. It is poorly absorbed from the gastrointestinal tract, forms insoluble complexes within the lumen, and prevents the absorption of dietary phosphate. A 63-year-old female with a 7-year history of peritoneal dialysis, who was treated with lanthanum carbonate for four years, underwent endoscopic submucosal dissection for intramucosal gastric cancer. Resected specimens showed massive accumulation of macrophages containing fine, granular, brown material in the lamina propria. This was confirmed as lanthanum deposition by scanning electron microscopy with energy dispersive x-ray spectroscopy. Although lanthanum may be poorly absorbed, increased tissue accumulation of lanthanum, particularly in the liver and bone, has been reported in animals with chronic kidney disease. This report indicates enhanced gastrointestinal absorption of lanthanum in some patients or conditions, although its clinical significance awaits further studies.
authors.affiliation: Department of Diagnostic Pathology, Shinonoi General Hospital, Nagano, Japan.
authors.forename: Mutsuki
authors.initials: M
authors.lastname: Makino
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawaguchi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Shimojo
authors.forename: Hironori
authors.initials: H
authors.lastname: Nakamura
authors.forename: Masaki
authors.initials: M
authors.lastname: Nagasawa
authors.forename: Ryo
authors.initials: R
authors.lastname: Kodama
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry* / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000737:chemistry* / Q000473:pathology; D006801:Humans; D054559:Hyperphosphatemia / Q000188:drug therapy / Q000209:etiology; D007811:Lanthanum / Q000032:analysis / Q000627:therapeutic use*; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000473:pathology; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy; D013052:Spectrometry, X-Ray Emission; D013274:Stomach Neoplasms / Q000737:chemistry* / Q000473:pathology
chemical_list: C119467:lanthanum carbonate; D007811:Lanthanum
keywords: chronic kidney disease; gastrointestinal absorption; lanthanum carbonate