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De Silva L, Udeshika K, De Silva S, Amarathunga P. Russell body cervicitis: A case report and literature review highlighting diagnostic pitfalls. Case Rep Womens Health 2025; 46:e00707. [PMID: 40297197 PMCID: PMC12036074 DOI: 10.1016/j.crwh.2025.e00707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Revised: 03/31/2025] [Accepted: 04/03/2025] [Indexed: 04/30/2025] Open
Abstract
Russell bodies have been observed in various inflammatory and neoplastic conditions, although their presence in the female genital tract is rare, with fewer than ten documented cases of Russell body cervicitis. This case report appears to be the first of Russell body cervicitis identified during pregnancy. A 28-year-old woman, at 20 weeks of gestation, underwent a cervical polypectomy after a polyp was detected incidentally during a cervical cerclage procedure. Pathological examination revealed an inflamed endocervical polyp with predominant plasma cell infiltrate. Most of the plasma cells contained intracytoplasmic Russell bodies and there were some Mott cells. Immunohistochemical stains confirmed the polyclonal nature of the plasma cell infiltrate. This report highlights the diagnostic challenges associated with Russell body cervicitis, given its rarity and histological resemblance to other inflammatory and neoplastic conditions. A review of the literature reveals that the few reported cases presented as a non-neoplastic process during reproductive age, with an uneventful follow-up. This report contributes to the limited knowledge of Russell body cervicitis, particularly in the context of pregnancy.
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Affiliation(s)
- Lalani De Silva
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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2
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Domínguez Cañete JJ, Platas Moreno I. [Duodenitis Russell bodies. Review of the entity and associations beyond H. pylori]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2024; 57:190-197. [PMID: 38971619 DOI: 10.1016/j.patol.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/24/2024] [Accepted: 02/13/2024] [Indexed: 07/08/2024]
Abstract
Plasma cells known as "Mott cells" present non-secretable accumulations of immunoglobulins called "Russell bodies". Its presence is related to hematological neoplasms, but it can appear in chronic inflammatory processes. The most common occurrence within the digestive tract is the gastric antrum associated with H. pylori infection. Our patient is added the rare extragastric cases where the association with H. pylori is inconsistent. We have found a frequent appearance of lower digestive and urological neoplasms in relation to these cases, justified by the expression of circulating cytokines in the tumor area that lead to the overactivation of plasma cells. This possible association could lead us to know data about the tumor environment and serve us for early diagnosis or future therapeutic targets.
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Kobayashi G, Imai T, Sentani K. Distribution and Clinicopathological Features of Mott Cells (Plasma Cells Containing Russell Bodies) in Gastric Cancer: Presence of Mott Cells Is Associated with Favorable Prognosis. J Clin Med 2024; 13:658. [PMID: 38337351 PMCID: PMC10856670 DOI: 10.3390/jcm13030658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
Gastric cancer (GC) is still one of the leading causes of cancer-related mortality. We previously reported the relationship between histological heterogeneity of tumor cells and molecular features in GC. The tumor microenvironment also has a crucial role in GC progression and therapeutic resistance. In this study, we focused on the tumor microenvironment, especially inflammatory cells in GC. Using GC tissue slides, we investigated the distribution and clinicopathological significance of inflammatory cell counts including eosinophils, neutrophils, lymphocytes, and plasma cells. Additionally, we investigated the relationship between Mott cells (plasma cells containing Russell bodies) and clinicopathological features. In neoplastic gastric mucosa, a high number of plasma cells was associated with low T-grade, early stage, and good prognosis. We then focused on Mott cells and found that their presence in neoplastic gastric mucosa was associated with lower T and N grades, early stage, and Helicobacter pylori infection and was inversely associated with CD44 and EGFR expression. Additionally, the presence of Mott cells was associated with good prognosis in advanced GC and was an independent favorable prognostic predictor. The presence of Mott cells in GC might be one useful prognostic predictor, and Mott cells might have an important role in the carcinogenesis of H. pylori infection.
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Affiliation(s)
- Go Kobayashi
- Laboratory of Molecular Pathology, Department of Molecular Biosciences, Radiation Effects Research Foundation, Hiroshima 732-0815, Japan;
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Takeharu Imai
- Department of Surgical Oncology, Graduate School of Medicine Gifu University, Gifu 501-1194, Japan;
| | - Kazuhiro Sentani
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
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Flerova E, Inniss S, Nwaoduah N, Denicola RP, Huang J. Acute systemic infection-associated Russell body gastroesophagitis: A case report and literature review. HUMAN PATHOLOGY REPORTS 2023; 31:300696. [DOI: 10.1016/j.hpr.2023.300696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
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Luo S, Huang X, Li Y, Wang J. Surveillance of Russell body inflammation of the digestive tract: a case report and review of literature. Diagn Pathol 2022; 17:67. [PMID: 36002890 PMCID: PMC9404552 DOI: 10.1186/s13000-022-01242-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 06/15/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Russell body inflammation of the digestive tract (RBIDT) is a rare chronic inflammation of the digestive tract mucosa that commonly presents as Russell body gastritis (RBG). This disease is usually associated with Helicobacter pylori (HP) infection. However, it can also occur in individuals without HP infection and with specific immune profiles, as seen in HIV and hepatitis C infections. The aetiology and pathogenesis of this disease remain controversial. Given the rarity of the disease and the diversity of the immunophenotypes, there is a high probability of misdiagnosis. Case presentation A male patient with RBG and HP infection was included in this study. The case of RBG with an unusual morphology of Mott cells that mimics stamped ring cells.Endoscopy performed during the follow-up revealed regression of the lesion 1 week after anti-HP treatment. Conclusions A case of RBG with a high likelihood of misdiagnosis of signet ring cell carcinoma (SRC) has been reported in this study along with a review of the relevant literature and an overview of RBIDT.
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Affiliation(s)
- Shuai Luo
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, P.R. China
| | - Xiang Huang
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, P.R. China
| | - Yao Li
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, P.R. China
| | - Jinjing Wang
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, P.R. China.
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Garcia GE, Hiba MR, Staffetti J. Russell Body Esophagitis: A Possible Indication to Screen for Hematologic Malignancy. Cureus 2022; 14:e26291. [PMID: 35770181 PMCID: PMC9236189 DOI: 10.7759/cureus.26291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
This is a case of an elderly man with lymphoplasmacytic lymphoma on a direct oral anticoagulant for atrial fibrillation who presented with weakness. Esophagogastroduodenoscopy found herpes esophagitis and islands of salmon-colored mucosa suspicious for Barrett’s esophagus. Biopsies showed no signs of Barrett’s Esophagus but returned positive for Russell bodies. This is the only reported case of Russell body esophagitis in the absence of Barrett’s esophagus. This case adds to the mounting evidence that Russell body esophagitis and potentially all gastrointestinal Russell bodies should prompt further work-up for hematologic malignancy.
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Tan WK, Smith R, George A, Gibbons A, Shaukat S, Kassam R, Roberts P. Russell Body Lesions of the Colon: Case Report and Literature Review. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2021; 77:309-312. [PMID: 34158452 DOI: 10.4166/kjg.2021.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 01/04/2023]
Abstract
Russell bodies (RB) are rare manifestations within the lower gastrointestinal tract. To date, there are only three other reported cases of RB lesions of the colon; two were polyps, and the third was a case of a multifocal RB lesion of the gastrointestinal tract. This paper reports a case of a tubulovillous adenoma with RB of the sigmoid colon in a patient diagnosed incidentally as part of the UK National Health Service Bowel Cancer Screening Programme. A thorough hematological investigation is required to exclude hematological malignancies because of its association with plasma cell neoplasm. These lesions should undergo clonality analysis to exclude the monoclonal proliferation of plasma cells. Ideally, a bone marrow aspirate and investigations for amyloidosis should be performed to exclude underlying hematological malignancies.
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Affiliation(s)
- W Keith Tan
- Department of Gastroenterology and Hepatology, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, United Kingdom.,MRC Cancer Unit, University of Cambridge, Cambridge, United Kingdom.,Department of Gastroenterology, Addenbrookes Hospital, Cambridge University NHS Foundation Trust, Cambridge, United Kingdom
| | - Rachel Smith
- Department of Gastroenterology, Addenbrookes Hospital, Cambridge University NHS Foundation Trust, Cambridge, United Kingdom
| | - Anthony George
- Department of Gastroenterology, Addenbrookes Hospital, Cambridge University NHS Foundation Trust, Cambridge, United Kingdom
| | - Anita Gibbons
- Department of Gastroenterology and Hepatology, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, United Kingdom
| | - Syed Shaukat
- Department of Gastroenterology and Hepatology, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, United Kingdom
| | - Rizwan Kassam
- Department of Gastroenterology and Hepatology, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, United Kingdom
| | - Phil Roberts
- Department of Gastroenterology and Hepatology, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, United Kingdom
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Al-Rawaf S, Alowami S, Riddell R, Naqvi A. Russell Body Typhlitis: A Case Report and Literature Review. Int J Surg Pathol 2021; 29:877-881. [PMID: 33829929 DOI: 10.1177/10668969211008251] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Russell bodies are accumulation of immunoglobulin in plasma cells forming intracytoplasmic inclusions. Russell body colitis is rare with only 3 cases described in the English literature up to date. We report a 78-year-old male with cirrhosis showing prominent cecal infiltration of Russell body containing plasma cells. Plasma cells showed no nuclear atypia or mitoses, and no evidence of light chain restriction. In this article, we report a fourth case of Russell body colitis, that is unique in being localized to the cecum in contrast to the other 3, 1 of which was in an inflammatory polyp in the sigmoid colon, 1 in a rectal tubulovillous adenoma and 1 as part of diffuse gastrointestinal disease. This is therefore the first report of localized Russell body typhlitis, occurring in a cirrhotic patient in whom an adjacent erosion was likely nonsteroidal anti-inflammatory drug-associated, a combination that may have facilitated the formation of Russell bodies.
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Bozhkova DM, Koleva-Ivanova MS, Belovejdov VT, Dikov DI. Malignant gastrointestinal stromal tumor in association with Russell body gastritis-A case report. INDIAN J PATHOL MICR 2021; 64:S89-S91. [PMID: 34135145 DOI: 10.4103/ijpm.ijpm_842_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Russell body gastritis (RBG) is an unusual form of chronic inflammation characterized by accumulation of plasma cells containing Russell bodies (RB) in the gastric mucosa. Although its pathogenesis has not been fully evaluated, there is evidence to support a strong association with Helicobacter pylori infection. Only four cases of RBG in association with malignant epithelial gastric tumors were reported. We report the first case of RBG in peritumoral mucosa of a malignant gastrointestinal stromal tumor in association with coccoid form of Helicobacter pylori and a follow-up.
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Affiliation(s)
- Desislava M Bozhkova
- Department of General and Clinical Pathology, Medical University of Plovdiv; UMHAT "Kaspela", Plovdiv, Bulgaria
| | - Maria S Koleva-Ivanova
- Department of General and Clinical Pathology, Medical University of Plovdiv; St. George University Hospital, Plovdiv, Bulgaria
| | - Veselin T Belovejdov
- Department of General and Clinical Pathology, Medical University of Plovdiv; St. George University Hospital, Plovdiv, Bulgaria
| | - Dorian I Dikov
- Department of General and Clinical Pathology, Medical University of Plovdiv, Plovdiv, Bulgaria; Service d'Anatomie et Cytologie Pathologiques, Grand Hôpital de l'Est Francilien, Jossigny, France
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Peruhova M, Peshevska-Sekulovska M, Georgieva V, Panayotova G, Dikov D. Surveilling Russell body Helicobacter pylori-negative gastritis: A case report and review of literature. World J Gastroenterol 2020; 26:5050-5059. [PMID: 32952348 PMCID: PMC7476171 DOI: 10.3748/wjg.v26.i33.5050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/03/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Russell body gastritis (RBG) is very rare type of chronic inflammation of gastric mucosa. The pathologic hallmark of the disease is Russell bodies (RB) which represent accumulation of eosinophilic cytoplasmic inclusions in endoplasmic reticulum of mature plasma cells (Mott cells). Most published cases are associated with Helicobacter pylori (H. pylori) infection because of correlation between plasma cell activation and antigenic stimulation. There are insufficient data about H. pylori-negative RBG and very little is known about the natural course of the disease. CASE SUMMARY A 51-year-old male patient underwent endoscopic screening for mild iron deficiency anemia. Gastroscopy revealed diffuse hyperemia, edema and nodularity of the fundic and corpus mucosa. Due to non-specific endoscopic findings and iron-deficiency anemia our preliminary diagnosis was diffuse type of gastric carcinoma or gastric lymphoma. Biopsy specimens of gastric mucosa showed inflammatory infiltrate rich in Mott cells, consisting entirely of cytoplasmic RB. Absence of nuclear atypia and mitosis of the plasma cells, polyclonal pattern of the Mott cells and negative staining for cytokeratins favored diagnosis of RBG. The patient was treated with proton-pump inhibitor for 8 wk. Long-term clinical and endoscopic surveillance was scheduled. Albeit, there was no improvement in endoscopic features of the gastric mucosa in three consecutive gastroscopies, histopathological findings demonstrated that the chronic inflammatory infiltrate in the fundic mucosa is less pronounced, rich in plasma cells, with almost absent RB and Mott cells. CONCLUSION The prognosis of this entity is uncertain, that is why these patients are subjects of continuous follow up.
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Affiliation(s)
- Milena Peruhova
- Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
| | | | - Viktoriya Georgieva
- Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
| | - Gabriela Panayotova
- Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
| | - Dorian Dikov
- Department of General and Clinical pathology, Grand Hôpital de l'Est Francilien, Jossigny 77600, France
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UĞUR KILINÇ AN, ŞENER BD. Russell body gastritis associated with gastric adenocarcinoma. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2020. [DOI: 10.25000/acem.703719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Umakoshi M, Miyabe K, Ishii H, Kudo-Asabe Y, Ito Y, Yoshida M, Maeda D, Sageshima M, Goto A. A case of Russell body gastritis with multifocal lesions. SAGE Open Med Case Rep 2020; 8:2050313X20923840. [PMID: 32577282 PMCID: PMC7290262 DOI: 10.1177/2050313x20923840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/12/2020] [Indexed: 11/16/2022] Open
Abstract
Russell body gastritis is an extremely rare gastritis characterized by abundant infiltration of plasma cells with Russell body and eccentric nuclei, known as Mott cells. An 81-year-old Japanese woman with Helicobacter pylori and hepatitis C virus infection complaining of abdominal discomfort underwent upper gastrointestinal endoscopy, which detected an elevated lesion 2 cm in diameter at the anterior wall of the gastric body. A histological examination of the lesion revealed the infiltration of numerous Mott cells with an abundant eosinophilic crystal structure and eccentric nuclei in the lamina propria, resulting in a pathological diagnosis of Russell body gastritis. Endoscopic submucosal dissection (ESD) was performed subsequently. The histological findings of the resected specimen were compatible with those of Russell body gastritis. Upper gastrointestinal endoscopy performed 2 months after endoscopic submucosal dissection revealed the presence of new multiple flat elevated lesions in the antrum up to 1 cm in diameter, distant from the site of endoscopic submucosal dissection. A histological examination revealed a few Mott cells in the biopsy specimens taken from the new lesions. In turn, H. pylori eradication therapy was performed 1 month after the detection of the new lesions. One year after the eradication therapy, follow-up upper gastrointestinal endoscopy revealed that multiple lesions had almost disappeared, and the histological examination of the gastric biopsy specimens confirmed the disappearance of Mott cells. We herein report a case of Russell body gastritis in which multifocal lesions were observed after endoscopic submucosal dissection, and which was subsequently treated by H. pylori eradication therapy.
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Affiliation(s)
- Michinobu Umakoshi
- Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine, Akita, Japan
| | - Ken Miyabe
- Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine, Akita, Japan
| | - Hajime Ishii
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | - Yukitsugu Kudo-Asabe
- Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yukinobu Ito
- Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine, Akita, Japan
| | - Makoto Yoshida
- Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine, Akita, Japan
| | - Daichi Maeda
- Department of Clinical Genomics, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Akiteru Goto
- Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine, Akita, Japan
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Abstract
We report an unusual case of Barrett's esophagus with prominent intramucosal Russell bodies, also known as Russell body Barrett's esophagus. We present this case to emphasize the importance of recognizing this unusual entity. It also represents a potential diagnostic pitfall because the distended plasma cells may be mistaken for signet ring cells of gastric adenocarcinoma or low-grade lymphoma. Hence, an awareness of this entity is important to avoid diagnostic confusion.
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Affiliation(s)
- Pooja Dhorajiya
- Department of Pathology, Icahn School of Medicine at Mount Sinai West, Mount Sinai Health System, New York, NY
| | - Rifat Mannan
- Department of Pathology, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, PA
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Gastric Xanthoma Associated with Gastric Cancer Development: An Updated Review. Can J Gastroenterol Hepatol 2020; 2020:3578927. [PMID: 32149048 PMCID: PMC7054765 DOI: 10.1155/2020/3578927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 12/23/2019] [Indexed: 02/07/2023] Open
Abstract
Gastric xanthelasma (GX) is a rare tumor-like lesion customarily found as an incidental finding due to its asymptomatic appearance. Grossly, it is a well-marked yellow-white plaque created in the lamina propria by microscopic clusters of foamy macrophages. Xanthelasma is rarely correlated with gastric hyperplastic polyps; gastric xanthomas are rare benign lesions that appear to be associated with inflammation of the gastric mucosa. Etiopathogenesis is also unclear, but it has been suggested to be involved in chronic gastritis, infection with Helicobacter pylori (H. pylori), diabetes mellitus, and hyperlipidemia. The gastric xanthoma prevalence ranges from 0.23% to 7%. Orth first described the condition in 1887. It has been found that xanthelasmas are associated with chronic gastritis, gastrointestinal anastomosis, intestinal metaplasia, and H. pylori infection. These lesions predispose patients to gastric cancer conditions. Xanthoma (GX) was reported to be a predictive marker for early gastric cancer. However, the effectiveness of these scores and xanthoma (GX) as predictive markers for early gastric cancer detected after H. pylori eradication remains unknown.
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Abstract
Russell body gastritis is caused by an accumulation of plasma cells
within the gastric mucosa. These plasma cells are characterized by
eosinophilic cytoplasmic inclusions of immunoglobulin which are called
“Russell bodies”. We report a case of Russell body gastritis in a
28-year-old male who presented with abdominal pain and rectal
bleeding. Endoscopy showed erosions with edema and vascular congestion
in the gastric body and antrum. The biopsy showed chronic gastritis
with plasma cell infiltration of the lamina propria. Many plasma cells
contained cytoplasmic Russell bodies which stained positive for CD138,
CD79a, Kappa and lambda light chains. The Russell bodies were negative
for pancytokeratin, excluding signet ring cell carcinoma. Russell body
gastritis is an uncommon, benign reactive condition.
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Affiliation(s)
- J Qiao
- Department of Pathology, Texas Tech University Health Science Center/Paul L Foster School of Medicine, El Paso, Texas, U.S.A
| | - E Dudrey
- Department of Pathology and Medical Education, Texas Tech University Health Science Center/Paul L Foster School of Medicine, El Paso, Texas, U.S.A
| | - S Gilani
- Department of Pathology, Texas Tech University Health Science Center/Paul L Foster School of Medicine, El Paso, Texas, U.S.A
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Vazmitsel MA, Laziuk K, Hammer RD. Localized accumulation of kappa restricted Russell body-containing plasma cells in tonsil. Clin Case Rep 2019; 7:1766-1768. [PMID: 31534745 PMCID: PMC6745347 DOI: 10.1002/ccr3.2372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 06/25/2019] [Accepted: 07/13/2019] [Indexed: 11/10/2022] Open
Abstract
An abnormal clonal plasma cell proliferation with Russell bodies is rare in chronic inflammatory reactions in adult patients. We describe the first case of light chain restricted Russell body accumulation within germinal centers of lymphoid follicles of the tonsil in a child. This should not be confused with a neoplastic process.
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Affiliation(s)
- Maryna A. Vazmitsel
- Department of Pathology and Anatomical SciencesUniversity of Missouri School of MedicineColumbiaMissouri
| | - Katsiaryna Laziuk
- Department of Pathology and Anatomical SciencesUniversity of Missouri School of MedicineColumbiaMissouri
| | - Richard D. Hammer
- Department of Pathology and Anatomical SciencesUniversity of Missouri School of MedicineColumbiaMissouri
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Analysis of clinical and histopathological findings in Russell body gastritis and duodenitis. Ann Diagn Pathol 2019; 40:66-71. [PMID: 31031217 DOI: 10.1016/j.anndiagpath.2019.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/09/2019] [Accepted: 04/02/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Russell body gastritis is considered as a rare, benign, incidental finding characterized by dense accumulation of plasma cells containing Russell bodies in the lamina propria. In this study, clinical and histopathological features of 12 cases of Russell body gastritis/duodenitis were presented. MATERIALS AND METHODS Clinical data, histopathological findings including Helicobacter pylori infection, Sydney system classification, Russell body density and immunohistochemical findings were evaluated in 11 gastric and 1 duodenal mucosal biopsy from 11 patients. RESULTS Six cases were male, 5 were female and the mean age was 72 (44-87). The most common site was antrum (10/12), one case was located in cardia and one in heterotopic gastric mucosa of duodenal bulb. H. pylori was detected in half of the cases. One of the cases was accompanied by gastric tubular adenoma, one by gastric well-differentiated adenocarcinoma and one by plasma cell neoplasm. In all cases, globules were positive with PAS stain. CONCLUSION Russell body gastritis must be kept in mind while reporting endoscopic biopsies because this entity may be misdiagnosed as signet ring carcinoma and may be associated with neoplasms. Absence of nuclear atypia, mucin stains, cytokeratins, plasma cell and hematolymphoid antigen markers are useful in differential diagnosis. Associated H. pylori infection, as well as rarely carcinomas, adenomas and plasma cell neoplasms, may be observed.
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Russell Bodies and Russell Body Inflammatory Polyp in the Colorectum: A Review of Clinicopathologic Features. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2845291. [PMID: 30151376 PMCID: PMC6087615 DOI: 10.1155/2018/2845291] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/15/2018] [Indexed: 12/17/2022]
Abstract
Colorectal mucosa with Russell bodies is a reactive inflammatory lesion composed of mature plasma cells, known as Mott cells which contain multiple intracytoplasmic eosinophilic globules. To the best of our knowledge, 3 case reports of colorectal Russell body containing lesions have been reported in the English literature (searched from 1980 to date), including just one case report of Colonic Russell body inflammatory polyp. Their importance lies in being aware of this unusual entity, recognizing it as well as the clinical scenario in which this typically arises and differentiating it from its malignant mimics that come in the histologic differential. This review discusses the clinical and endoscopic presentation, histopathologic features, ancillary studies, pathogenesis, differential diagnosis, prognosis, and treatment of this rare lesion.
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Abstract
This manuscript presents a review of infectious causes of gastritis aimed at the practicing anatomic pathologist. We shall highlight unique histologic findings and clinical attributes that will assist those analyzing endoscopically obtained mucosal biopsies of the stomach or resection specimens.
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Cortes-Santiago N, Schady DA. Kappa restricted Russell body gastroenteritis in two pediatric patients. HUMAN PATHOLOGY: CASE REPORTS 2018. [DOI: 10.1016/j.ehpc.2017.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Joo M. Rare Gastric Lesions Associated with Helicobacter pylori Infection: A Histopathological Review. J Pathol Transl Med 2017; 51:341-351. [PMID: 28592787 PMCID: PMC5525039 DOI: 10.4132/jptm.2017.04.03] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 04/03/2017] [Indexed: 12/20/2022] Open
Abstract
Helicobacter pylori infection is associated with chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. However, some rare gastric lesions exhibiting distinctive histological features may also be associated with H. pylori infection, including lymphocytic gastritis, granulomatous gastritis, Russell body gastritis, or crystal-storing histiocytosis. Although diverse factors can contribute to their development, there is convincing evidence that H. pylori infection may play a pathogenic role. These findings are mainly based on studies in patients with these lesions who exhibited clinical and histological improvements after H. pylori eradication therapy. Thus, H. pylori eradication therapy might be indicated in patients with no other underlying disease, particularly in countries with a high prevalence of H. pylori infection. This review describes the characteristic histological features of these rare lesions and evaluates the evidence regarding a causative role for H. pylori infection in their pathogenesis.
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Affiliation(s)
- Mee Joo
- Department of Pathology, Inje University Ilsan Paik Hospital, Goyang, Korea
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Parra Vargas V, Aponte DM, Álvarez EA. Unusual presentation of infection by Helicobacter pylori: gastritis associated with Russell bodies, infrequent and poorly understood pathology. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2016; 109:80-81. [PMID: 27990837 DOI: 10.17235/reed.2016.4303/2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Russell bodies gastritis is a very rare disease, with few cases reported in literature, and characterized by the finding of plasma cells with eosinophilic intracytoplasmic inclusions in the gastric mucosa, called Mott cells. Although it has been partnered since its first description to Helicobacter pylori infection, it is important to considered differential diagnoses such as lymphoplasmacytic lymphoma, mucosa-associated lymphoid tissue (MALT) lymphoma, plasmacytoma and signet ring cell carcinom. In this case report, we address a patient with histologic confirmation and her follow up.
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Abstract
Russell body gastroenteritis has been reported as a reactive inflammatory process in most cases and many of the reports were from the upper gastrointestinal tract, especially the stomach, which may be associated with Helicobacter pylori infection and rarely associated with gastric carcinoma. Russell body containing Mott cells have been rarely seen in Barrett’s esophagus and duodenum, and only 2 cases have been reported in colon, including a transplant patient with diarrhea and a rectal tubulovillous adenoma. In this article, we report another localized form of Russell body containing Mott cells in colon as an inflammatory polyp without adenomatous change.
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Affiliation(s)
- Ryan F. Coates
- University of Vermont Medical Center, Burlington, VT, USA
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Takahashi T, Morita T, Matsuno Y. Primary Extramedullary Plasmacytoma in the Gastroduodenal Canal Associated With Epstein-Barr Virus–Associated Adenocarcinoma of the Stomach. Int J Surg Pathol 2016; 24:757-762. [DOI: 10.1177/1066896916659359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The coexistent occurrence of a lymphoid neoplasm with adenocarcinoma of the stomach is rare. We report herein a case of gastroduodenal extramedullary plasmacytoma simultaneously complicated by multiple gastric Epstein-Barr virus (EBV)–associated adenocarcinomas. The patient underwent distal gastrectomy to treat an adenocarcinoma occupying the gastric antrum. Histopathological examination revealed a massive submucosal plasma cell proliferation adjacent to the adenocarcinoma involving the pylorus to the duodenal bulb. Lambda immunoglobulin light chain restriction indicated that these plasma cells were monoclonal. Because the clinical investigation revealed no other lymphoid neoplasms, primary extramedullary plasmacytoma of the stomach was diagnosed. The histological examination of the resected stomach revealed 3 additional adenocarcinomas invading from the mucosa to the submucosa. A thorough histological examination of the remnant stomach resected 2 weeks after the first surgery revealed 2 additional adenocarcinomas in the remnant specimen, yielding a total of 6 carcinomas, all of which represented EBV-associated gastric carcinomas (EBV-GC). This is the second case report of gastric plasmacytoma concurrent with adenocarcinoma. Moreover, the plasmacytoma showed a conspicuous morphologic feature resembling Mott cells. Because Helicobacter pylori (HP) infection was also elucidated, this rare case may indicate a role of EBV or HP in carcinogenesis of both adenocarcinoma and lymphoplasmacytic neoplasms.
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Goto A, Okamoto T, Matsumoto M, Saito H, Yanai H, Itoh H, Sakaida I. Chronological Endoscopic and Pathological Observations in Russell Body Duodenitis. Clin Endosc 2016; 49:387-90. [PMID: 26999017 PMCID: PMC4977740 DOI: 10.5946/ce.2015.131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 01/18/2016] [Accepted: 01/27/2016] [Indexed: 01/01/2023] Open
Abstract
A 64-year-old man was found to have a nodule in his right lung. He also complained of nausea and abdominal pain during the clinical course. Esophagogastroduodenoscopy revealed a duodenal ulcer associated with severe stenosis and a suspicion of malignancy. However, three subsequent biopsies revealed no evidence of malignancy. The fourth biopsy showed scattered large eosinophilic cells with an eccentric nucleus, leading to a diagnosis of Russell body duodenitis (RBD). RBD is an extremely rare disease, and little is known about its etiology and clinical course. The pathogenesis of RBD is discussed based on our experience with this case.
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Affiliation(s)
- Atsushi Goto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takeshi Okamoto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Masaharu Matsumoto
- Department of Gastroenterology and Hepatology, Hagi Civil Hospital, Hagi, Japan
| | - Hiroyuki Saito
- Department of General Medicine, Hagi Civil Hospital, Hagi, Japan
| | - Hideo Yanai
- Department of Gastroenterology and Hepatology, Kanmon Medical Center, Shimonoseki, Japan
| | - Hiroshi Itoh
- Department of Molecular Pathology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Isao Sakaida
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
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Muthukumarana V, Segura S, O'Brien M, Siddiqui R, El-Fanek H. "Russell Body Gastroenterocolitis" in a Posttransplant Patient: A Case Report and Review of Literature. Int J Surg Pathol 2015; 23:667-72. [PMID: 26310272 DOI: 10.1177/1066896915601893] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Russell bodies represent a cellular response to overstimulation of plasma cells, leading to the accumulation of abundant, nondegradable, condensed immunoglobulin in dilated rough endoplasmic reticulum cisternae. Russell body gastritis was first described 1998 by Tazawa and Tsutsumi. Since then only 39 cases involving the gastrointestinal tract have been reported in English literature, which include Russell body gastritis, duodenitis, and esophagitis. We report a case of a 44-year-old female with a history of diabetes mellitus, status post kidney and pancreas transplant who presented with multiple episodes of watery diarrhea associated with abdominal pain, nausea, and vomiting. Upper gastroendoscopic examination showed diffuse mild erythema in the gastric body and a clean-based duodenal ulcer. Lower gastroendoscopic examination was normal. Examination of multiple biopsies from duodenal, gastric, terminal ileum, and colonic mucosae revealed numerous plasma cells with abundant eosinophilic granular cytoplasm (Russell bodies) and eccentric nuclei, highlighted by PAS stain and CD 138 plasma cell marker. Helicobacter pylori stains were performed on gastric biopsies and were negative for organisms. To date, there are no cases described in English literature with multifocal Russell body infiltrates in gastrointestinal tract in a single patient including ileum and/or colon. This makes our case the first to be reported with these unique findings; thus, the spectrum of Russell body-associated chronic inflammation of the gastrointestinal tract would be more suitably referred to as "Russell body gastroenterocolitis."
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Affiliation(s)
| | - Sheila Segura
- Western Connecticut Health Network, Danbury, CT, USA
| | | | - Rina Siddiqui
- Western Connecticut Health Network, Danbury, CT, USA
| | - Hani El-Fanek
- Western Connecticut Health Network, Danbury, CT, USA
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Russell body gastritis/duodenitis: a case series and description of immunoglobulin light chain restriction. Clin Res Hepatol Gastroenterol 2014; 38:e89-97. [PMID: 25001185 DOI: 10.1016/j.clinre.2014.05.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/21/2014] [Accepted: 05/28/2014] [Indexed: 02/04/2023]
Abstract
Russell body esophago-gastro-duodenitis is an unusual form of chronic inflammation, with only 22 cases being reported in PubMed. However, the prevalence and clinical significance remain unknown. This report describes the clinico-pathological characteristics of nine cases of Russell body gastritis (RBG) and one case of Russell body duodentitis (RBD), with nonspecific endoscopic appearance. The Mott cells (plasma cells with Russell bodies) showed κ light chain restriction in eight gastritis cases and λ light chain restriction in the duodentitis case, and there were no histological features that suggested lymphoma. Thus, a diagnosis of monoclonal RBG/RBD was made. Helicobacter pylori infection was found in 55.6% of RBG cases and in the RBD case. And, the clinical follow-up evaluations were uneventful. This report is the first study to describe this benign disease entity with monoclonality on a large-scale basis. In addition, the monoclonality of Mott cells cannot be used as evidence of an existing neoplastic lesion, and taken together, these findings may indicate a reactive process.
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Araki D, Sudo Y, Imamura Y, Tsutsumi Y. Russell body gastritis showing IgM kappa-type monoclonality. Pathol Int 2014; 63:565-7. [PMID: 24274720 DOI: 10.1111/pin.12105] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Daiju Araki
- Department of Pathology, Fujita Health University School of Medicine, Toyoake, Japan; Medical Student of Fujita Health University School of Medicine, Toyoake
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Klair JS, Girotra M, Kaur A, Aduli F. Helicobacter pylori-negative Russell body gastritis: does the diagnosis call for screening for plasmacytic malignancies, especially multiple myeloma? BMJ Case Rep 2014; 2014:bcr2013202672. [PMID: 24671320 PMCID: PMC3975488 DOI: 10.1136/bcr-2013-202672] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2014] [Indexed: 12/19/2022] Open
Abstract
Russell body gastritis (RBG) is a rare entity with unestablished pathophysiology, endoscopic findings, clinical manifestations and treatments. Literature is scarce on this clinical entity with unclear clinical significance. Of 18 cases reported, 12 tested (+) for Helicobacter pylori and improved with treatment, but it remains unclear whether this link is coincidental or bears some clinical significance. We describe a case of elderly woman who had a follow-up oesophagogastroduodenoscopy for chronic peptic ulcers, and biopsy showed positive immunohistochemical stains for κ and λ, indicating a polytypic population of plasma cells. Immunostaining for H pylori was negative. Biopsies were also (-) for gastric carcinoma, lymphoma and plasmacytoma. Considering her RGB-suggestive histology and her symptoms of bone pains and anaemia, multiple myeloma screening was considered clinically relevant. The purpose of this review was to educate clinicians and gastroenterologists about this unique entity and explore its association with multiple myeloma or other plamacytic malignancies.
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Affiliation(s)
- Jagpal Singh Klair
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mohit Girotra
- Department of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Aneet Kaur
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Farshad Aduli
- Department of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Russell body gastroenteritis: an aberrant manifestation of chronic inflammation in gastrointestinal mucosa. Case Rep Med 2013; 2013:797264. [PMID: 24198839 PMCID: PMC3808711 DOI: 10.1155/2013/797264] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 09/11/2013] [Indexed: 12/18/2022] Open
Abstract
First described in 1998, Russell body gastritis is a rare chronic inflammatory condition characterized by abundant intramucosal polyclonal plasma cells, which contain intracytoplasmic eosinophilic globules of immunoglobulins (Russell bodies) that displace the nucleus, with an accompanying chronic inflammatory infiltrate. Russell bodies represent a cellular response to overstimulation of plasma cells, leading to the accumulation of abundant, nondegradable, condensed immunoglobulin in dilated rough endoplasmic reticulum cisternae. Russell body gastritis usually occurs in the gastric antrum, but two cases of Russell body duodenitis have been recently described. Herein, we report an unusual case of Barrett esophagus with prominent lymphoplasmacytic infiltration and Russell bodies, which expands the current spectrum of Russell body gastritis/duodenitis. Given the various anatomic locations in which Russell body gastritis may arise, we suggest that “Russell body gastroenteritis” may be a more appropriate designation for this uncommon reactive condition.
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Kai K, Miyahara M, Tokuda Y, Kido S, Masuda M, Takase Y, Tokunaga O. A case of mucosa-associated lymphoid tissue lymphoma of the gastrointestinal tract showing extensive plasma cell differentiation with prominent Russell bodies. World J Clin Cases 2013; 1:176-180. [PMID: 24303496 PMCID: PMC3845945 DOI: 10.12998/wjcc.v1.i5.176] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 04/22/2013] [Accepted: 05/08/2013] [Indexed: 02/05/2023] Open
Abstract
A 73-year-old Japanese woman was hospitalized for detailed examination of nausea, diarrhea and loss of appetite. Atypical erosion in the ileum was found on endoscopy. Biopsy of this erosion showed proliferation of cells containing numerous Russell bodies. Differential diagnoses considered were Russell body enteritis, crystal-storing histiocytosis, Mott cell tumor, immunoproliferative small intestinal disease (IPSID) and mucosa-associated lymphoid tissue (MALT) lymphoma. The cells containing prominent Russell bodies showed diffuse positivity for CD79a and CD138, but negative results for CD20, CD3, UCHL-1, CD38 and CD68. Russell bodies were diffusely positive for lambda light chain, but negative for kappa light chain, and immunoglobulin (Ig) G, IgA and IgM. Based on these findings, Russell body enteritis, crystal-storing histiocytosis and IPSID were ruled out. As the tumor formed no mass lesions and was restricted to the gastrointestinal tract, MALT lymphoma with extensive plasma cell differentiation was finally diagnosed. The patient showed an unexpectedly aggressive clinical course. The number of atypical lymphocytes in peripheral blood gradually increased and T-prolymphocytic leukemia (T-PLL) emerged. The patient died of T-PLL 7 mo after admission. Autopsy was not permitted.
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Takahashi Y, Shimizu S, Uraushihara K, Fukusato T. Russell body duodenitis in a patient with retroperitoneal metastasis of ureteral cancer. World J Gastroenterol 2013; 19:125-8. [PMID: 23326174 PMCID: PMC3542750 DOI: 10.3748/wjg.v19.i1.125] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Revised: 09/26/2012] [Accepted: 10/16/2012] [Indexed: 02/06/2023] Open
Abstract
Russell bodies are globular and eosinophilic inclusion bodies in the cytoplasm of mature plasma cells. Plasma cells whose cytoplasm is filled with Russell bodies are designated as Mott cells. Russell body duodenitis (RBD) is a unique form of chronic duodenitis that is characterized by infiltration of numerous Mott cells. RBD is very rare; only two cases have been reported to date. In this paper, we report a case of RBD in a patient with retroperitoneal metastasis of ureteral cancer. A 77-year-old man was admitted to our hospital complaining of appetite loss, vomiting, and upper abdominal distension. He had undergone left nephroureterectomy for ureteral cancer 4 years earlier. Upper digestive tract endoscopy revealed edema, stenosis, and punctate redness of the mucosa of the duodenum, and a biopsy was performed. Histological analysis showed that numerous Mott cells had infiltrated the lamina propria mucosae, and the condition was diagnosed as RBD. A mass lesion in the retroperitoneum adjacent to the duodenum was detected by abdominal computed tomography, and was diagnosed as metastatic urothelial carcinoma by biopsy. It is possible that chemokines produced by tumor cells caused RBD in this case.
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Yoon JB, Lee TY, Lee JS, Yoon JM, Jang SW, Kim MJ, Lee SJ, Kim TO. Two Cases of Russell Body Gastritis Treated by Helicobacter pylori Eradication. Clin Endosc 2012; 45:412-6. [PMID: 23251890 PMCID: PMC3521944 DOI: 10.5946/ce.2012.45.4.412] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 03/07/2012] [Accepted: 03/19/2012] [Indexed: 01/13/2023] Open
Abstract
Russell body gastritis was first defined in 1998, but not many cases have been reported since then. The exact causes and process of this condition are unknown yet; however, considering the reported cases, it has been highly suggested to have correlation with Helicobacter pylori infection. Russell body gastritis has a non-specific clinical presentation of gastritis such as gastric mucosal edema in the macroscopic view. It can be mistaken as xanthoma, signet ring cell carcinoma, or a malignant lymphoma including mucosa-associated lymphoid tissue lymphoma and plasmocytoma. Russell body gastritis features polyclonal immunoglobulin and is differentiated from Mott cancer, of which immune globulin has monoclonal aspect. Authors report here two cases of Russell body gastritis with examined endoscopic findings as well as a review of related literature on the association of all reported cases of Russell body gastritis with H. pylori infection.
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Affiliation(s)
- Jung Bin Yoon
- Department of Internal Medicine, Good Samsun Hospital, Busan, Korea
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Paniz Mondolfi A, Samuel M, Kikhney J, Moter A, Feldman D, Slova D, Filatov A, Theise N. Russell body duodenitis: a histopathological and molecular approach to a rare clinical entity. Pathol Res Pract 2012; 208:415-9. [PMID: 22673188 DOI: 10.1016/j.prp.2012.05.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 05/08/2012] [Indexed: 12/16/2022]
Abstract
Russell bodies are pink eosinophilic accumulations within plasma cells. To date, two hypotheses have attempted to elucidate the biological events behind the formation of these bodies. One theory sustains that such bodies constitute cytoplasmic accumulation of immunoglobulin derivatives contained in the perinuclear cistern of the smooth endoplasmic reticulum because of an increased synthesis or altered secretion. On the other hand, since its initial description in the medical literature, several authors have attributed the formation of such bodies to the presence of microorganisms such as in the case of Russell body gastritis and its association to Helicobacter pylori infection. In an attempt to possibly characterize the presence of an infectious organism, we performed a thorough biomolecular analysis on a case of a 69-year-old female presenting with Russell body duodenitis which, to the best of our knowledge, constitutes the second report of this clinical entity in the English literature. In light that the events behind formation of such bodies in H. pylori-negative individuals remain unclear, we hypothesize on the possible pathways that could have led to their reactive mechanical and immune derivation.
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Affiliation(s)
- Alberto Paniz Mondolfi
- Department of Pathology and Laboratory Medicine, St. Luke's-Roosevelt Hospital Center (Columbia University College of Physicians and Surgeons), New York, NY 10025, USA.
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Choi J, Eun Lee H, Byeon SJ, Nam KH, Kim MA, Kim WH. Russell body gastritis presented as a colliding lesion with a gastric adenocarcinoma: A case report. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1755-9294.2012.01127.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Complete remission of gastric plasmacytoma following eradication of "Candidatus Helicobacter heilmannii". Clin J Gastroenterol 2012; 5:158-63. [PMID: 26182161 DOI: 10.1007/s12328-012-0287-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 01/23/2012] [Indexed: 10/28/2022]
Abstract
This is the first case report of gastric plasmacytoma associated with "Candidatus Helicobacter heilmannii" ('H. heilmannii') infection. The patient was a 40-year-old woman with epigastric discomfort. Upper gastrointestinal endoscopy demonstrated a white granular lesion on the wall of the gastric body. Histological studies showed numerous eosinophilic globules expanding the lamina propria mucosae. Immunohistochemically, the cells with these globules stained positive for CD138, CD79a, immunoglobulin (Ig) M, and kappa light chain, but negative for CD20, IgG, IgA, and lambda light chain. A diagnosis of plasmacytoma was made. Although a Helicobacter pylori infection was not detected, the patient received H. pylori eradication treatment. Two months after H. pylori eradication treatment, an upper gastrointestinal endoscopy showed a reduction of the white granular lesion. Eighteen months after eradication treatment, endoscopy, endoscopic ultrasonography and histological studies revealed complete remission of the lesion. No relapse has been documented 30 months after the initial diagnosis of plasmacytoma. Retrospectively, analysis of biopsy specimens removed before eradication treatment demonstrated that this patient had 'H. heilmannii' infection. Therefore, H. pylori eradication therapy should be considered as a potential first-line therapy for early-stage gastric plasmacytoma with or without H. pylori infection.
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Wolf EM, Mrak K, Tschmelitsch J, Langner C. Signet ring cell cancer in a patient with Russell body gastritis--a possible diagnostic pitfall. Histopathology 2011; 58:1178-80. [PMID: 21707721 DOI: 10.1111/j.1365-2559.2011.03876.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Abstract
Russell body gastritis refers to the accumulation of plasma cells containing Russell bodies within the lamina propria. This report describes the first case of monoclonal Russell body gastritis without the previously reported associations.
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Gobbo AD, Elli L, Braidotti P, Nuovo FD, Bosari S, Romagnoli S. Helicobacter pylori-negative Russell body gastritis: Case report. World J Gastroenterol 2011; 17:1234-6. [PMID: 21448431 PMCID: PMC3063919 DOI: 10.3748/wjg.v17.i9.1234] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 09/25/2010] [Accepted: 10/02/2010] [Indexed: 02/06/2023] Open
Abstract
Russell body gastritis is an unusual form of chronic gastritis characterized by the permeation of lamina propria by numerous plasma cells with eosinophilic cytoplasmic inclusions. Very few cases have been reported in the literature; the majority of which have shown Helicobacter Pylori (H. pylori) infection, thus suggesting a correlation between plasma cell presence and antigenic stimulation by H. pylori. We present a case of Russell body gastritis in a 78-year-old woman who was undergoing esophagogastroduodenoscopy for epigastric pain. Gastric biopsy of the gastroesophageal junction showed the presence of cells with periodic acid-Schiff-positive hyaline pink bodies. Giemsa staining for H. pylori infection was negative, as well as immunohistochemical detection. The cells with eosinophilic inclusions stained positive for CD138, CD79a, and κ and lambda light chains, which confirmed plasma cell origin. In particular, κ and lambda light chains showed a polyclonal origin and the patient was negative for immunological dyscrasia. The histological observations were confirmed by ultrastructural examination. The cases reported in the literature associated with H. pylori infection have shown regression of plasma cells after eradication of H. pylori. Nothing is known about the progression of H. pylori-negative cases. The unusual morphological appearance of this type of chronic gastritis should not be misinterpreted during routine examination, and it should be distinguished from other common forms of chronic gastritis. It is mandatory to exclude neoplastic diseases such as gastric carcinoma, lymphoma and plasmocytoma by immunohistochemistry and electron microscopy, which can help with differential diagnosis. The long-term effects of plasma cells hyperactivation are still unknown, because cases of gastric tumor that originated in patients affected by Russell body gastritis have not been described in the literature. We are of the opinion that these patients should be scheduled for endoscopic surveillance.
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Affiliation(s)
- Claudine Habib
- Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts, USA
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Abstract
CONTEXT The pathologist plays the leading role in distinguishing pseudoneoplasms from truly neoplastic lesions in the gastrointestinal tract. OBJECTIVE This review was conducted to heighten awareness of pseudoneoplasms, to help differentiate among the various types of pseudoneoplasms, and to help distinguish pseudoneoplasms from malignancies. DATA SOURCES This review is based on the medical literature on pseudoneoplasms in MEDLINE and the authors' own experiences. Reference lists of retrieved articles were also reviewed to identify additional articles. CONCLUSIONS A classification of pseudoneoplasms, according to the mechanism of injury to the gastrointestinal tract, morphologic patterns, and heterotopia, may be useful in providing a diagnostic framework in which ancillary techniques often have a diagnostic role. Several pseudoneoplasms may be closely associated with true neoplasms (eg, malakoplakia, prolapsetype lesions) because of the nonspecific nature of the response of the intestine to injury.
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Shinozaki A, Ushiku T, Fukayama M. Prominent Mott cell proliferation in Epstein-Barr virus-associated gastric carcinoma. Hum Pathol 2009; 41:134-8. [PMID: 19665167 DOI: 10.1016/j.humpath.2009.07.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Revised: 07/03/2009] [Accepted: 07/09/2009] [Indexed: 12/16/2022]
Abstract
The proliferation of Mott cells (plasma cells with multiple Russell bodies) is rarely observed in nonhematopoietic tumors, and no reports of this phenomenon in malignant epithelial neoplasms have been published. We present 2 cases of gastric carcinoma associated with prominent Mott cell proliferation. Histologically, both tumors consisted of extensive lymphoplasmacytic infiltration and numerous Mott cells with dysplastic epithelial cells. The epithelial cells showed overt cytologic atypia; infiltrating cells did not show cytologic atypia, immunoglobulin light chain restriction, or clonal immunoglobulin gene rearrangement. In situ hybridization for Epstein-Barr virus (EBV)-encoded small RNA (EBER) labeled the carcinoma cells but not the lymphoplasmacytic cells. The Mott cell accumulation was a reactive phenomenon in gastric carcinoma associated with EBV. The differential diagnosis included primary gastric lymphoma and nonneoplastic conditions such as Russell body gastritis; EBER in situ hybridization was helpful in their differentiation.
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Affiliation(s)
- Aya Shinozaki
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
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Dos Santos JN, Ramos EAG, Gurgel CAS, Barros AC, de Freitas AC, Crusoé-Rebello IM. Russell body apical periodontitis: an unusual case report. ACTA ACUST UNITED AC 2008; 106:903-8. [PMID: 18926736 DOI: 10.1016/j.tripleo.2008.07.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Revised: 07/25/2008] [Accepted: 07/26/2008] [Indexed: 11/15/2022]
Abstract
Russell bodies (RBs) changes in chronic apical lesions have rarely been reported in the literature. We describe a case of a periapical lesion abundantly and extensively composed of RB. Microscopic examination showed accumulation of plasma cells containing globular, spherical, polygonal, and eosinophilic structures against fibrous connective tissue. Initial diagnostic considerations based on a smaller magnification included hypersecretory plasmocytoma, although there was no evidence of infiltrative growth, mitotic activity, nuclear atypia, or cellular pleomorphism. Then, a panel of immunohistochemical markers was applied and the cells showed positivity with both kappa and lambda chains demonstrating their polyclonal origin. The extensive accumulation of RBs involving the periapical region represents an unreported and significant histologic change, as it was mimicking a malignant neoplasm.
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Affiliation(s)
- Jean Nunes Dos Santos
- Laboratory of Oral Surgical Pathology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil.
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Abstract
We present a case of plasma cell predominant lymphoplasmacyte-rich meningioma with numerous crystalline inclusions. A 72-year-old woman presented with 1-year history of memory disturbance and an MRI revealing a right frontal extra-axial mass. Histology showed a benign meningioma with multifocal accumulation of numerous large cells with abundant eosinophilic cytoplasm, filled with lamellar inclusions and bipyramidal crystals. In addition, some classic plasma cells, mastocytes and lymphocytes were also detected. The crystal-containing cells were positive by CD79a and PGM1 and expressed polyclonal light chains, with kappa predominance. Electron microscopy showed crystals with needle or rectangular shape in plasma cells. Plasma cell inclusions have been reported occasionally in reactive inflammatory lesions but more frequently in plasma cell tumors and lymphoplasmacytic lymphoma, maybe associated with crystal-storing histiocytosis. Although plasma cell predominant lymphoplasmacyte-rich meningioma is not uncommon, to our knowledge, similar crystalline inclusions in plasma cells have not been reported previously in meningioma.
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Soltermann A, Koetzer S, Eigenmann F, Komminoth P. Correlation of Helicobacter pylori virulence genotypes vacA and cagA with histological parameters of gastritis and patient's age. Mod Pathol 2007; 20:878-83. [PMID: 17541440 DOI: 10.1038/modpathol.3800832] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The histological parameters of Helicobacter pylori (H. pylori) gastritis are dependent on the virulence factor profile of the microbe, which includes the cytotoxins vacA (vacuolating cytotoxin A) and cagA (cytotoxin-associated gene A) as well as the duration of infection. The virulence factor genotypes vacA and cagA were assessed by the line probe reverse hybridization assay INNO-LiPA and correlated with the histological parameters of H. pylori infection, in particular intestinal metaplasia (IM) as well as with the patient's age. A total of 120 patients were analyzed; 47 patients with IM in the antrum and 73 control patients without this alteration. The vacA s1 cagA+ genotype (high virulence) correlated with the presence of antral IM, a more intense acute inflammation in both antrum and corpus and the formation of ulcer. The vacA m1 genotype (high virulence) correlated with a more intense acute inflammation in only the corpus as well as more prominent Russell bodies in the antrum. H. pylori strains with the vacA s2 m2 cagA- genotype (low virulence) were rarely found in these conditions (all P <0.05). No correlation with the virulence status was found for the type and extent of IM, the intensity of chronic inflammation, the formation of lymphoid follicles and the microbial density. Furthermore, patients with IM were 7 years older than their counterparts without (P<0.05). Finally, there was a trend for more virulent vacA s1 m1 cagA+ strains to be found in younger individuals (P>0.05). The virulence genotype of the microbe is an important determinant for the severity of the gastritis and the formation of antral IM. Age is an additional factor for the development of IM.
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Affiliation(s)
- Alex Soltermann
- Department of Pathology, Institute of Surgical Pathology, University Hospital Zürich, Zürich, Switzerland.
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Pizzolitto S, Camilot D, DeMaglio G, Falconieri G. Russell body gastritis: expanding the spectrum of Helicobacter pylori - related diseases? Pathol Res Pract 2007; 203:457-60. [PMID: 17395398 DOI: 10.1016/j.prp.2007.01.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2006] [Accepted: 01/19/2007] [Indexed: 12/16/2022]
Abstract
We report a new case of Helicobacter pylori gastritis showing plasma cell infiltrates with extensive formation of Russell bodies (Mott cells) within the lamina propria of the antral mucosa. The patient was a 60-year-old woman with a history of epigastric pain. Endoscopy revealed non-specific congestion of the mucosa. Microscopically, the intracytoplasmic inclusions were homogeneous, mainly round to oval, and pushed the nucleus toward the periphery. They were intensely PAS-positive and reacted to antibodies against polytypic light chains, CD79a, and anti-plasma cell antibody. Because of the accumulation of intracytoplasmic inclusions, Russell body gastritis is a potential source of diagnostic difficulties in endoscopic biopsy specimens that can be confused with immunocytic neoplasms, such as lymphoplasmacytic lymphoma or plasmocytoma, or signet-ring cell carcinoma. In the light of similar cases published previously, it seems as if the association between Russell body gastritis and Helicobacter pylori infection is not merely coincidental.
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Affiliation(s)
- Stefano Pizzolitto
- Department of Pathology, General Hospital S. Maria della Misericordia, Udine, Italy
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Paik S, Kim SH, Kim JH, Yang WI, Lee YC. Russell body gastritis associated with Helicobacter pylori infection: a case report. J Clin Pathol 2007; 59:1316-9. [PMID: 17142575 PMCID: PMC1860539 DOI: 10.1136/jcp.2005.032185] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
An unusual and rare gastric mucosal lesion histologically consisting of a localised accumulation of Russell bodies and Russell body-containing plasma cells, the so-called Mott cells, has been recognised only recently and termed as "Russell body gastritis". This lesion, despite its densely monomorphous appearance is easily confirmed to be non-neoplastic by its polyclonal immunoreactive pattern to immunoglobulin light chains. However, the aetiology of Russell body gastritis is controversial and hence the optimal treatment for this disease has not been established. Two cases of Russell body gastritis associated with Helicobacter pylori infection are reported, and the possible role of H pylori infection in the pathogenesis is discussed.
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Affiliation(s)
- S Paik
- Department of Diagnostic Pathology, Bundang Jesaeng General Hospital, Sungnam-si, Kyungki-do, Korea
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Wolkersdörfer GW, Haase M, Morgner A, Baretton G, Miehlke S. Monoclonal gammopathy of undetermined significance and Russell body formation in Helicobacter pylori gastritis. Helicobacter 2006; 11:506-10. [PMID: 16961813 DOI: 10.1111/j.1523-5378.2006.00443.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Infection by Helicobacter pylori has been linked to monoclonal gammopathy of undetermined significance (MGUS). MGUS is thought to develop due to chronic antigenic stimulation in people with a specific genetic predisposition. METHODS AND RESULTS We describe a patient presenting with dyspepsia associated with H. pylori-related erosive gastritis. Histopathologic findings revealed infiltration with plasma cells containing accumulated condensed intercisternal immunoglobulins, the so-called 'Russell bodies'. In addition, MGUS was present with total immunoglobulins within the normal range but a significantly decreased serum concentration of IgG subtype 3. Molecular analyses demonstrated IgH formation, T-cell receptor gamma rearrangement, and alterations within the IgHG3 gene sequence. Following H. pylori eradication, gastritis and dyspepsia gradually resolved but MGUS persisted for at least 22 months. CONCLUSIONS This is the first report to demonstrate that upon infection with H. pylori, an impaired secretory capacity of plasma cells due to specific molecular changes can present as Russell body gastritis. The molecular findings question a pathogenetic link between Russell bodies and H. pylori, but suggest genetic alterations in the immunoglobulin locus as the possible cause for both MGUS and Russell body gastritis.
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Affiliation(s)
- Gernot W Wolkersdörfer
- Department of Internal Medicine I and Institute for Pathology, University of Technology Dresden, Dresden, Germany.
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Drut R, Olenchuk AB. Images in pathology. Russell body gastritis in an HIV-positive patient. Int J Surg Pathol 2006; 14:141-2. [PMID: 16703175 DOI: 10.1177/106689690601400206] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Ricardo Drut
- Department of Pathology, Hospital de Ninos Superiora Sor Maria Ludovica, 1900 La Plata, Argentina
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