International Journal of Surgical Pathology

20(1) 69 70
The Author(s) 2012
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DOI: 10.1177/1066896911416115
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Case Reports
A 49-year-old man presented with nausea, epigastric pain,
and weight loss. The patient, an ex-intravenous drug user,
was hepatitis C positive and had insulin-dependent diabe-
tes mellitus. A gastroscopy was performed and the find-
ings were reported as severe, raised, erosive gastritis with
associated edematous duodenitis with erythema. Biopsies
were performed which showed numerous Russell body
containing plasma cells (Mott cells) within the lamina
propria (Figure 1) and a diagnosis of Russell body (Mott
cell) gastritis was made. Immunohistochemistry showed
the Mott cells to be positive for IgM kappa (Figure 2) with
negative staining for IgG, IgA, and lambda light chain
(Figure 3). Immunohistochemistry for Helicobacter was
negative. There was no evidence of intestinal metaplasia,
dysplasia, or neoplasia.
Ten previous cases of Russell body gastritis have so far
been reported.
1-9
Eight of these have had concomitant
Helicobacter pylori infection, some with resolution of the
gastritis following eradication of the organism. This has
led some authors to conclude an etiological association.
However, 2 cases were not associated with Helicobacter
infection.
2,6
One of these patients had monoclonal gam-
mopathy of uncertain significance and a polyclonal Mott
cell gastric infiltrate,
2
whereas the second case occurred
in a HIV-positive patient.
6
HIV positivity is, however,
unlikely to be a specific association as one of the patients
with Helicobacter-associated Russell body gastritis was
also HIV positive.
8
In addition, Helicobacter-induced
gastritis is not usually associated with Russell body
containing plasma cells.
Stewart and Spagnola
10
reported 3 cases of Helicobacter-
associated gastritis with crystalline plasma cell inclusions.
Two of these cases showed lambda light chain restric-
tion and had normal serum electrophoresis. Stewart and
416115IJSXXX10.1177/1066896911416115Coyne
and AzadehInternational Journal of Surgical Pathology
1
Royal Liverpool Hospital, Liverpool, UK
Corresponding Author:
John D. Coyne, Royal Liverpool Hospital, Prescott Street,
Liverpool, L7 8XP, UK
Email: johnnycoyne@doctors.org.uk
Russell Body Gastritis: A Case Report
John D. Coyne
1
, FRCPath and Bahram Azadeh
1
, FRCPath
Abstract
Russell body gastritis refers to the accumulation of plasma cells containing Russell bodies within the lamina propria. This
report describes the first case of monoclonal Russell body gastritis without the previously reported associations.
Keywords
Russell body, Mott cell, gastritis
Figure 1. Lamina propria containing abundant Mott cells
Figure 2. Positive staining for kappa light chain
70 International Journal of Surgical Pathology 20(1)
Spagnola suggested that this indicated an expanded mono-
clonal but reactive clone of plasma cells with the immuno-
globulin predisposed to crystal formation. Mott cells have
also been described in EpsteinBarr virusassociated
gastric carcinoma, hematopoietic tumors with plasmacytic
differentiation, rectal adenoma, lymphoproliferative disor-
ders, and in Barretts esophagus.
11-13
This case further
expands the spectrum of Russell body gastritis because of
the fact that it is monoclonal, and is unassociated with HIV
and Helicobacter infection. Furthermore, this case supports
the contention that Mott cell gastritis represents an idiosyn-
cratic, abnormal accumulation of immunoglobulin, possi-
bly due to impaired secretion and which on occasion may
manifest as a benign but monoclonal proliferation. It is con-
sidered, in the opinion of the authors, that a shared similar
etiology may not be a prerequisite.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
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Figure 3. Negative reaction with lambda light chain
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