Clin Endosc > Volume 57(2); 2024 > Article
CME for
KSGE members
Gong and Bang: Whitish gastric mucosa on upper gastrointestinal endoscopy


A 60-year-old man with hypertension and chronic glomerulonephritis visited the gastroenterology department for upper gastrointestinal endoscopy. He has been undergoing continuous ambulatory peritoneal dialysis for the past 8 years. He denied having any symptoms, and the vital signs were normal. On laboratory tests, the serum levels of hemoglobin, calcium, phosphorus, blood urea nitrogen, and creatinine were 9.8 g/dL, 9.5 mg/dL, 4.9 mg/dL, 71.3 mg/dL, and 11.8 mg/dL, respectively. His current medications are olmesartan, felodipine, lanthanum carbonate, calcitriol, cinacalcet hydrochloride, atorvastatin, darbepoetin alfa, and multi-vitamins. Endoscopy revealed diffuse whitish granular mucosa on the greater curvature side, posterior wall of the high body, and cardia (Fig. 1AD). The patient had no Helicobacter pylori infection.
What is the most likely diagnosis?


Conflicts of Interest
Chang Seok Bang is currently serving as a KSGE Publication Committee member; however, he was not involved in peer reviewer selection, evaluation, or the decision process in this study. The other author has no potential conflicts of interest.
Author Contributions
Conceptualization: CSB; Data curation: EJG; Visualization: EJG; Writing–original draft: all authors; Writing–review & editing: all authors.

Fig. 1.
Endoscopic and histologic findings. (A–C) Diffuse whitish granular mucosa on the greater curvature side, posterior wall side of high body, and cardia on white-light imaging. (D) Diffuse whitish granular mucosa on the greater curvature side, posterior wall side of high body, and cardia on narrow-band imaging. (E, F) Histiocytes aggregating in superficial lamina propria (hematoxylin & eosin stain: E, ×100; F, ×200).


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