Russell body gastritis/duodenitis: A case series and description of immunoglobulin light chain restriction

• Published in: Clinics and research in hepatology and gastroenterology Vol. 38; no. 5; pp. e89 - e97
• Main Authors: Zhang, Hejun, Jin, Zhu, Cui, Rongli
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.10.2014
• Subjects: Adult; Aged; Chronic Disease; Duodenitis - immunology; Duodenitis - pathology; Female; Gastritis - immunology; Gastritis - pathology; Gastroenterology and Hepatology; Humans; Immunoglobulin Light Chains - immunology; Internal Medicine; Male; Middle Aged; Plasma Cells - immunology; Plasma Cells - pathology; Young Adult; RBs; RBBO; Igs; HIV; RBD; RBG; Russell body gastritis; Russell bodies; Russell body duodentitis; Russell body Barrett's esophagitis; human immunodeficiency virus; immunoglobulins
• ISSN: 2210-7401; 2210-741X; 2210-741X
• DOI: 10.1016/j.clinre.2014.05.008

Russell body esophago-gastro-duodenitis is an unusual form of chronic inflammation, with only 22 cases being reported in PubMed. However, the prevalence and clinical significance remain unknown. This report describes the clinico-pathological characteristics of nine cases of Russell body gastritis (RBG) and one case of Russell body duodentitis (RBD), with nonspecific endoscopic appearance. The Mott cells (plasma cells with Russell bodies) showed κ light chain restriction in eight gastritis cases and λ light chain restriction in the duodentitis case, and there were no histological features that suggested lymphoma. Thus, a diagnosis of monoclonal RBG/RBD was made. Helicobacter pylori infection was found in 55.6% of RBG cases and in the RBD case. And, the clinical follow-up evaluations were uneventful. This report is the first study to describe this benign disease entity with monoclonality on a large-scale basis. In addition, the monoclonality of Mott cells cannot be used as evidence of an existing neoplastic lesion, and taken together, these findings may indicate a reactive process.