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 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...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.展开更多
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 ...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 narrowband 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.展开更多
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.
文摘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.
文摘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 narrowband 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.
