Chronological Endoscopic and Pathological Observations in Russell Body Duodenitis

Russell body duodenitis: a rare condition

Russell bodies are accumulations of immunoglobulins within hyperstimulated plasma cells of the intestinal mucosa associated with chronic inflammation of benign progression, but may be confused with lymphoplasmacytic lymphoma, MALT lymphoma, multiple myeloma, or "signet-ring" cells, among others. There are few cases of gastric involvement, but duodenal involvement is even rarer with less than 10 published cases. Endoscopic examination with quality biopsies and anatomopathologic analysis with immunohistochemistry are essential to make an adequate differential diagnosis with other more severe processes. In any case, the treatment is that of the underlying disease.

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.

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.