Elastotic Changes in the Gastrointestinal Tract: A Review of Literature

Abstract

Elastotic changes are benign lesions in the gastrointestinal tract that often appear as polyps and show histologically a remarkable increase in elastic fibers. Because of their hyaline and amorphous appearance in hematoxylin and eosin (H&E) stained slides, elastotic changes often resemble amyloidosis. However, they are negative in Congo red staining. Reviewing the literature we found 35 cases in 12 publications in the English and French literature since 1985. The results indicate that the patients’ age ranged from 24 to 88 years (mean 58.2, median 58) and presented a balanced gender ratio (M/F = 17/18). Usually the lesions presented as polyps or irregular mucosal areas. Mostly, they were found during endoscopic examination in the colon or rectum (16 cases), while six cases were located in the stomach and only two in the small bowel. Some authors consider the alterations to be a reactive process, e.g. within (gastric) ulcers, whereas others speculate about a connection with systemic diseases of the connective tissue (Ehlers-Danlos Syndrome, Pseudoxanthoma elasticum). Based on our observations we distinguished angioelastosis, showing a relation to submucosal vessels, as a separate entity from gastrointestinal elastofibroma, that presents the same histologic morphology as Elastofibroma dorsi. Conclusion: Elastofibromatous changes in the gastrointestinal tract are quite common benign findings and should be considered as a possible differential diagnosis in examining gastrointestinal specimens.