Russell小体胃炎(Russell body gastritis,RBG)于1998年由Tazawa等[1]首次报道并命名。Russell小体胃炎是一种罕见的胃黏膜病变,其定义是胃黏膜中含有Russell小体浆细胞的胃炎,其特征是黏膜内含有嗜酸性细胞质的浆细胞的浸润。Russell...Russell小体胃炎(Russell body gastritis,RBG)于1998年由Tazawa等[1]首次报道并命名。Russell小体胃炎是一种罕见的胃黏膜病变,其定义是胃黏膜中含有Russell小体浆细胞的胃炎,其特征是黏膜内含有嗜酸性细胞质的浆细胞的浸润。Russell小体于1890年由Russell[2]首次提出是由于内质网和高尔基复合体在分泌球蛋白过程中被阻塞所形成。展开更多
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 in...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.展开更多
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 cel...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 mucosaassociated lymphoid tissue(MALT) lymphoma. The cells containing prominent Russell bodies showed diffuse positivity for CD79 a 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, Ig A and Ig M. 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.展开更多
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 t...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 nega-tive,as well as immunohistochemical detection.The cells with eosinophilic inclusions stained positive for CD138,CD79a,andκand lambda light chains,which confirmed plasma cell origin.In particular,κand 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.展开更多
文摘Russell小体胃炎(Russell body gastritis,RBG)于1998年由Tazawa等[1]首次报道并命名。Russell小体胃炎是一种罕见的胃黏膜病变,其定义是胃黏膜中含有Russell小体浆细胞的胃炎,其特征是黏膜内含有嗜酸性细胞质的浆细胞的浸润。Russell小体于1890年由Russell[2]首次提出是由于内质网和高尔基复合体在分泌球蛋白过程中被阻塞所形成。
文摘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.
文摘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 mucosaassociated lymphoid tissue(MALT) lymphoma. The cells containing prominent Russell bodies showed diffuse positivity for CD79 a 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, Ig A and Ig M. 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.
基金Supported by University of Milan Medical School,FIRST 2007
文摘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 nega-tive,as well as immunohistochemical detection.The cells with eosinophilic inclusions stained positive for CD138,CD79a,andκand lambda light chains,which confirmed plasma cell origin.In particular,κand 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.
