Russell body gastritis: a case series and review of literature

Abstract

Abstract Introduction/Objective Russell body gastritis is considered a rare finding characterized by Russell body-containing plasma cells in the lamina propria. Patients typically present with nonspecific findings. In this study, clinical and histopathological features of 3 cases with incidental findings of Russell body gastritis (RBG).<quillbot-extension- portal></quillbot-extension-portal> Methods/Case Report The Epic SlicerDicer tool was used to identify institutional cases between April 2022 to April 2023 using the keyword “Russell Body”. Using the PubMed database, we searched for articles published between January 2003 and April 2023, with the keyword "Russell body gastritis". Studies that described novel RBG cases were included.<quillbot-extension- portal></quillbot-extension-portal> Results (if a Case Study enter NA) The three cases were female with a mean age of 47 (42-51). Two patients were presented with chronic dyspepsia and one patient was being evaluated for right upper quadrant pain. The endoscopic finding for one patient was significant for multifocal erythematous gastric mucosa and the other two patients had unremarkable findings. Biopsies from the three patients revealed active gastritis in 2 cases and inactive chronic gastritis in 1 case. A dense accumulation of plasma cells with Mott cells and Russell bodies were identified in the lamina propria. Helicobacter pylori was identified on H. pylori stain in one case. Upon further investigation, CD138 highlights the plasma cells and kappa and lambda ISH demonstrated polyclonal plasma cells and cytokeratin AE1:AE3 was negative for a carcinoma A review of 64 previously reported cases of RBG shows that the average age of presentation is 63. Half of the cases were associated with Helicobacter pylori infection. Other associated conditions include multiple myeloma (3%) and HIV (6%). There have been 12 cases with monoclonal plasma cells with 10 cases of kappa-type monoclonality (including one case of duodenitis) and 1 case of lambda-type monoclonality.<quillbot-extension-portal></quillbot- extension-portal> Conclusion Most cases of RBG have been linked with helicobacter pylori. However, the underlying etiology is not well understood. Differentials include plasmacytoma, MALToma, and signet ring carcinoma. The clinical significance and its long-term effect remain unknown. Our report is the largest review of RBG. With its wide range of clinical presentations, additional cases are to define this entity better.<quillbot-extension-portal></quillbot-extension-portal>