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罗素小体胃炎/十二指肠炎症:病例系列及免疫球蛋白轻链限制的描述

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

作者信息

Zhang Hejun, Jin Zhu, Cui Rongli

机构信息

Pathological laboratory, Department of Gastroenterology, Peking University Third Hospital, No. 49 Road Huayuan North, Haidian District, 100191 Beijing, PR China.

Pathological laboratory, Department of Gastroenterology, Peking University Third Hospital, No. 49 Road Huayuan North, Haidian District, 100191 Beijing, PR China.

出版信息

Clin Res Hepatol Gastroenterol. 2014 Oct;38(5):e89-97. doi: 10.1016/j.clinre.2014.05.008. Epub 2014 Jul 4.

Abstract

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.

摘要

拉塞尔小体食管-胃-十二指肠炎是一种罕见的慢性炎症形式,在医学期刊数据库(PubMed)中仅报道过22例。然而,其患病率及临床意义仍不明确。本报告描述了9例拉塞尔小体胃炎(RBG)和1例拉塞尔小体十二指肠炎(RBD)的临床病理特征,内镜表现无特异性。在8例胃炎病例中,莫特细胞(含拉塞尔小体的浆细胞)显示κ轻链限制,在十二指肠炎病例中显示λ轻链限制,且无提示淋巴瘤的组织学特征。因此,诊断为单克隆RBG/RBD。55.6%的RBG病例及RBD病例中发现幽门螺杆菌感染。并且,临床随访评估无异常。本报告是首次大规模描述这种具有单克隆性的良性疾病实体的研究。此外,莫特细胞的单克隆性不能用作现有肿瘤性病变的证据,综合来看,这些发现可能表明是一种反应性过程。

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