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Chauhan D, Goyal S, Sakhuja P, Sonika U. Russell body typhilitis: An unusual mimicker of malignancy! J Clin Pathol 2024; 77:384-386. [PMID: 38286611 DOI: 10.1136/jcp-2023-209308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024]
Affiliation(s)
- Devika Chauhan
- Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India
| | - Surbhi Goyal
- Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India
| | - Puja Sakhuja
- Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India
| | - Ujjwal Sonika
- Department of Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India
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Martínez-Aracil A, Polanco-Alonso D, Stayerman C, Miguel C, Pérez de Nanclares G. Colonic adenomatous polyp with florid presence of monoclonal lambda Russell bodies: Case report and etiopathogenic hypothesis. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2024; 57:111-115. [PMID: 38599729 DOI: 10.1016/j.patol.2023.07.001] [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: 05/07/2023] [Revised: 06/15/2023] [Accepted: 07/09/2023] [Indexed: 04/12/2024]
Abstract
Russell bodies (RBs) are round eosinophilic intracytoplasmic inclusions formed by condensed immunoglobulins in mature plasma cells, which are called Mott cells. These cells are rarely found in the gastric tract, with even less cases reported in the colorectal region. There are still many questions about this event, as it is still unknown the relationship between the agents reported of increasing the probability of appearance of these cells and the generation of RBs. In this case report we describe the fifth patient presenting an infiltration of Mott cells in a colorectal polyp, being the second case with a monoclonal origin without a neoplastic cause, and the first one monoclonal for lambda. A comparison with previously similar reported cases is also done, and a possible etiopathogenic hypothesis proposed.
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Affiliation(s)
- Adriano Martínez-Aracil
- Pathology Service, Bioaraba Research Health Institute, Araba University Hospital, Vitoria-Gasteiz, Alava, Spain
| | - Diego Polanco-Alonso
- Molecular (Epi)Genetic Lab, Bioaraba Research Health Institute, Araba University Hospital, Vitoria-Gasteiz, Alava, Spain
| | - Celina Stayerman
- Laboratorio Technipath-Hospital del Valle, San Pedro Sula, Honduras
| | - Carlos Miguel
- Pathology Service, Bioaraba Research Health Institute, Araba University Hospital, Vitoria-Gasteiz, Alava, Spain
| | - Guiomar Pérez de Nanclares
- Molecular (Epi)Genetic Lab, Bioaraba Research Health Institute, Araba University Hospital, Vitoria-Gasteiz, Alava, Spain.
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Kiskaddon AL, Wilsey M, Gonzalez-Gomez I, Laks J, Miles A, Carapellucci J, Asante-Korang A. Basiliximab therapy for immune-mediated bowel disease in a pediatric heart transplant patient. Pediatr Transplant 2023; 27:e14443. [PMID: 36419214 DOI: 10.1111/petr.14443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/17/2022] [Accepted: 11/13/2022] [Indexed: 11/25/2022]
Abstract
In pediatric patients who undergo heart transplantation, severe immune-mediated bowel disease has been reported. Management is complex, and there are little data discussing the use of basiliximab for immune-mediated bowel disease. This case report discusses a pediatric patient who developed immune-mediated bowel disease following heart transplantation and was successfully managed with basiliximab.
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Affiliation(s)
- Amy L Kiskaddon
- Department of Pharmacy, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA.,Division of Pediatric Cardiology, Department of Pediatrics, Johns Hopkins University School of Medicine, Balitmore, Marlyand, USA
| | - Michael Wilsey
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
| | - Ignacio Gonzalez-Gomez
- Division of Pathology, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
| | - Jessica Laks
- Heart Institute, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
| | - Alyssa Miles
- Department of Pharmacy, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
| | | | - Alfred Asante-Korang
- Division of Pediatric Cardiology, Department of Pediatrics, Johns Hopkins University School of Medicine, Balitmore, Marlyand, USA.,Heart Institute, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
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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: 2] [Impact Index Per Article: 1.0] [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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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: 5] [Impact Index Per Article: 1.7] [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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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: 3] [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: 08/25/2020] [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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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: 13] [Impact Index Per Article: 2.6] [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: 5] [Impact Index Per Article: 0.8] [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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Yorita K, Iwasaki T, Uchita K, Kuroda N, Kojima K, Iwamura S, Tsutsumi Y, Ohno A, Kataoka H. Russell body gastritis with Dutcher bodies evaluated using magnification endoscopy. World J Gastrointest Endosc 2017; 9:417-424. [PMID: 28874963 PMCID: PMC5565508 DOI: 10.4253/wjge.v9.i8.417] [Citation(s) in RCA: 6] [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: 11/29/2016] [Revised: 03/13/2017] [Accepted: 04/24/2017] [Indexed: 02/06/2023] Open
Abstract
Russell body gastritis (RBG) is an unusual type of chronic gastritis characterized by marked infiltration of Mott cells, which are plasma cells filled with spherical eosinophilic bodies referred to as Russell bodies. It was initially thought that Helicobacter pylori (H. pylori) infection was a major cause of RBG and that the infiltrating Mott cells were polyphenotypic; however, a number of cases of RBG without H. pylori infection or with monoclonal Mott cells have been reported. Thus, diagnostic difficulty exists in distinguishing RBG with monoclonal Mott cells from malignant lymphoma. Here, we report an unusual case of an 86-year-old-Japanese man with H. pylori-positive RBG. During the examination of melena, endoscopic evaluation confirmed a 13-mm whitish, flat lesion in the gastric antrum. Magnification endoscopy with narrow-band imaging suggested that the lesion was most likely a poorly differentiated adenocarcinoma. Biopsy findings were consistent with chronic gastritis with many Mott cells with intranuclear inclusions referred to as Dutcher bodies. Endoscopic submucosal dissection confirmed the diagnosis of RBG with kappa-restricted monoclonal Mott cells. Malignant lymphoma was unlikely given the paucity of cytological atypia and Ki-67 immunoreactivity of monoclonal Mott cells. This is the first reported case of RBG with endoscopic diagnosis of malignant tumor and the presence of Dutcher bodies.
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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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