Russell body duodenitis in a patient with retroperitoneal metastasis of ureteral cancer

[Duodenitis Russell bodies. Review of the entity and associations beyond H. pylori]

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.

Distribution and Clinicopathological Features of Mott Cells (Plasma Cells Containing Russell Bodies) in Gastric Cancer: Presence of Mott Cells Is Associated with Favorable Prognosis

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.

Role of Uterine Telocytes During Pregnancy

Endometrial remolding and angiogenesis are critical events that occur during pregnancy in order to establish uteroplacental vascular communication. This study investigated the role of uterine telocytes (TCs) in pregnancy. We analyzed the distribution of TCs and morphological changes in the endometrium of the gravid rabbit uterus at different stages of pregnancy: after ovulation, pre-implantation (day 7), post-implantation (days 8 and 9), and mid-pregnancy (day 14) and late (days 21–28) pregnancy. TCs gradually increased with the progression of pregnancy. They had distinctive telopodes (TPs) and podoms, with intranucleolar chromatin. The TCs established contact with decidual cells, growing a glandular epithelium, blood vessels, and immune cells, such as lymphocytes, neutrophils, and macrophages. The TCs underwent morphological changes at the post-implantation phase. They acquired thick and voluminous TPs, formed an extensive three-dimensional (3D) labyrinth at mid-pregnancy, and exhibited irregular-shaped nuclei and a dilated rough endoplasmic reticulum at late pregnancy. They also acquired a convoluted contour-formed complex network. Scanning electron microscopy (SEM) showed an extensive 3D network in the endometrium, forming a condensed sheath at late pregnancy. Transmission electron microscopy and SEM detected fenestrated TPs, and TCs were identified by CD34 and vascular endothelial growth factor expression. TCs also expressed matrix metalloproteinase-9 and transforming growth factor beta-1. Results suggested that TCs might play an essential role in maternal placenta formation, especially decidualization, regulation of uterine gland development, and neovascularization of maternal uterine blood vessels.

Surveillance of Russell body inflammation of the digestive tract: a case report and review of literature

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.

Russell Body Typhlitis: A Case Report and Literature Review

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.

Malignant gastrointestinal stromal tumor in association with Russell body gastritis-A case report

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.

Analysis of clinical and histopathological findings in Russell body gastritis and duodenitis

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.

Russell Body Inflammatory Polyp

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.

Chronological Endoscopic and Pathological Observations in Russell Body Duodenitis

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.

"Russell Body Gastroenterocolitis" in a Posttransplant Patient: A Case Report and Review of Literature

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."