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Possibility of lanthanum absorption in the stomach.

Tonooka A, Uda S, Tanaka H, Yao A, Uekusa T - Clin Kidney J (2015)

Bottom Line: Lanthanum phosphate compounds were found histologically in the gastric mucosa and a regional lymph node and confirmed by scanning and transmission electron microscopy-energy-dispersive X-ray spectroscopy.These findings suggest that lanthanum is absorbed in the stomach and transported via lymph flow.This observation could prove helpful in future investigation of lanthanum disposition.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Pathology , Kanto Rosai Hospital , Kanagawa , Japan.

ABSTRACT
Lanthanum carbonate (LC) is an orally administered phosphate binder. Its absorption is generally thought to be minimal. We report here the case of an 81-year-old woman who underwent subtotal gastrectomy for gastric cancer after receiving hemodialysis for 1 year and taking LC for 7 months. Lanthanum phosphate compounds were found histologically in the gastric mucosa and a regional lymph node and confirmed by scanning and transmission electron microscopy-energy-dispersive X-ray spectroscopy. These findings suggest that lanthanum is absorbed in the stomach and transported via lymph flow. This observation could prove helpful in future investigation of lanthanum disposition.

No MeSH data available.


Related in: MedlinePlus

Light micrograph and SEM-EDS results of a regional lymph node. (A) Macrophages with granular cytoplasm in the lymph node (indicated by arrows). (B) SEM image of the lymph node showing bright elements (indicated by arrows). (C) EDS spectrum showing the presence of La and P at the area analyzed (indicated by the ‘+’ in B). (D) Magnified image of the analysis point showing granular substances.
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SFV062F2: Light micrograph and SEM-EDS results of a regional lymph node. (A) Macrophages with granular cytoplasm in the lymph node (indicated by arrows). (B) SEM image of the lymph node showing bright elements (indicated by arrows). (C) EDS spectrum showing the presence of La and P at the area analyzed (indicated by the ‘+’ in B). (D) Magnified image of the analysis point showing granular substances.

Mentions: Histological examination of the resected specimens showed that all three tumors (diameter, 2–15 mm) were well-differentiated tubular adenocarcinomas located in intestinal metaplastic mucosa with no submucosal invasion. No lymphovascular invasion or lymph node metastasis was observed. All the tumors were resected completely. In the lamina propria of the mucosa, however, we noticed many macrophages with abundant cytoplasm containing some basophilic material (Figure 1A and B). The macrophages were found grouped just beneath the epithelium and were widespread in the intestinal metaplastic mucosa, including in the neoplastic lesion (Figure 1C). Then, we analyzed the resected specimen by scanning electron microscopy–energy-dispersive X-ray spectroscopy (SEM-EDS) and transmission electron microscopy-EDS. In the macrophages, we found lanthanum deposits with a spectrum similar to that of LC (Figure 1D). Furthermore, similar macrophages were found histologically in a regional lymph node. Also, SEM-EDS showed that the lymph node contained lanthanum (Figure 2A–D). An elemental map of phosphorus and lanthanum indicates that they were deposited together (Figure 1E and F). Because the patient continued to take lanthanum after gastrectomy, we measured the plasma lanthanum concentration, which was 0.47 ng/mL (within the range of values in a control group of patients on dialysis who took lanthanum as a phosphate binder [6]). Three years after the surgery, the patient has shown no signs of recurrence and had no notable illness.Fig. 1.


Possibility of lanthanum absorption in the stomach.

Tonooka A, Uda S, Tanaka H, Yao A, Uekusa T - Clin Kidney J (2015)

Light micrograph and SEM-EDS results of a regional lymph node. (A) Macrophages with granular cytoplasm in the lymph node (indicated by arrows). (B) SEM image of the lymph node showing bright elements (indicated by arrows). (C) EDS spectrum showing the presence of La and P at the area analyzed (indicated by the ‘+’ in B). (D) Magnified image of the analysis point showing granular substances.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4581381&req=5

SFV062F2: Light micrograph and SEM-EDS results of a regional lymph node. (A) Macrophages with granular cytoplasm in the lymph node (indicated by arrows). (B) SEM image of the lymph node showing bright elements (indicated by arrows). (C) EDS spectrum showing the presence of La and P at the area analyzed (indicated by the ‘+’ in B). (D) Magnified image of the analysis point showing granular substances.
Mentions: Histological examination of the resected specimens showed that all three tumors (diameter, 2–15 mm) were well-differentiated tubular adenocarcinomas located in intestinal metaplastic mucosa with no submucosal invasion. No lymphovascular invasion or lymph node metastasis was observed. All the tumors were resected completely. In the lamina propria of the mucosa, however, we noticed many macrophages with abundant cytoplasm containing some basophilic material (Figure 1A and B). The macrophages were found grouped just beneath the epithelium and were widespread in the intestinal metaplastic mucosa, including in the neoplastic lesion (Figure 1C). Then, we analyzed the resected specimen by scanning electron microscopy–energy-dispersive X-ray spectroscopy (SEM-EDS) and transmission electron microscopy-EDS. In the macrophages, we found lanthanum deposits with a spectrum similar to that of LC (Figure 1D). Furthermore, similar macrophages were found histologically in a regional lymph node. Also, SEM-EDS showed that the lymph node contained lanthanum (Figure 2A–D). An elemental map of phosphorus and lanthanum indicates that they were deposited together (Figure 1E and F). Because the patient continued to take lanthanum after gastrectomy, we measured the plasma lanthanum concentration, which was 0.47 ng/mL (within the range of values in a control group of patients on dialysis who took lanthanum as a phosphate binder [6]). Three years after the surgery, the patient has shown no signs of recurrence and had no notable illness.Fig. 1.

Bottom Line: Lanthanum phosphate compounds were found histologically in the gastric mucosa and a regional lymph node and confirmed by scanning and transmission electron microscopy-energy-dispersive X-ray spectroscopy.These findings suggest that lanthanum is absorbed in the stomach and transported via lymph flow.This observation could prove helpful in future investigation of lanthanum disposition.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Pathology , Kanto Rosai Hospital , Kanagawa , Japan.

ABSTRACT
Lanthanum carbonate (LC) is an orally administered phosphate binder. Its absorption is generally thought to be minimal. We report here the case of an 81-year-old woman who underwent subtotal gastrectomy for gastric cancer after receiving hemodialysis for 1 year and taking LC for 7 months. Lanthanum phosphate compounds were found histologically in the gastric mucosa and a regional lymph node and confirmed by scanning and transmission electron microscopy-energy-dispersive X-ray spectroscopy. These findings suggest that lanthanum is absorbed in the stomach and transported via lymph flow. This observation could prove helpful in future investigation of lanthanum disposition.

No MeSH data available.


Related in: MedlinePlus