A case of Russell body gastritis with multifocal lesions
A case of Russell body gastritis with multifocal lesions
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DOI：
10.1177/2050313x20923840
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发表时间：
2020-06
影响因子：
0.8
通讯作者：
Michinobu Umakoshi;Ken Miyabe;H. Ishii;Yukitsugu Kudo-Asabe;Yukinobu Ito;Makoto Yoshida;D. Maeda;M. Sageshima;A. Goto
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文献类型：
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作者：
Michinobu Umakoshi;Ken Miyabe;H. Ishii;Yukitsugu Kudo-Asabe;Yukinobu Ito;Makoto Yoshida;D. Maeda;M. Sageshima;A. Goto
罗素体胃炎是一种极为罕见的胃炎，其特征是大量浆细胞浸润，具有罗素体和偏心核，称为莫特细胞。一名81岁的日本女性，患有幽门螺杆菌和丙型肝炎病毒感染，主诉腹部不适，接受了上消化道内镜检查，在胃体前壁发现一个直径2 cm的隆起病变。病变的组织学检查显示大量Mott细胞浸润，具有丰富的嗜酸性晶体结构和固有层中的偏心核，导致Russell体胃炎的病理诊断。随后进行了内镜粘膜下剥离术（ESD）。切除标本的组织学表现与Russell体胃炎一致。内镜下粘膜下剥离术后2个月进行的上消化道内镜检查显示，在远离内镜下粘膜下剥离部位的胃窦中存在直径达1 cm的新发多个平坦隆起病变。组织学检查显示，从新病变的活检标本中有一些莫特细胞。反过来，H.在检测到新病变后1个月进行幽门螺杆菌根除治疗。根除治疗后1年，随访的上消化道内窥镜检查显示多个病灶几乎消失，胃活检标本的组织学检查证实Mott细胞消失。我们在此报告一个罗素体胃炎的病例，在内视镜黏膜下剥离术后发现多病灶病变，并随后以H。幽门螺杆菌根除治疗。
Russell body gastritis is an extremely rare gastritis characterized by abundant infiltration of plasma cells with Russell body and eccentric nuclei, known as Mott cells. An 81-year-old Japanese woman with Helicobacter pylori and hepatitis C virus infection complaining of abdominal discomfort underwent upper gastrointestinal endoscopy, which detected an elevated lesion 2 cm in diameter at the anterior wall of the gastric body. A histological examination of the lesion revealed the infiltration of numerous Mott cells with an abundant eosinophilic crystal structure and eccentric nuclei in the lamina propria, resulting in a pathological diagnosis of Russell body gastritis. Endoscopic submucosal dissection (ESD) was performed subsequently. The histological findings of the resected specimen were compatible with those of Russell body gastritis. Upper gastrointestinal endoscopy performed 2 months after endoscopic submucosal dissection revealed the presence of new multiple flat elevated lesions in the antrum up to 1 cm in diameter, distant from the site of endoscopic submucosal dissection. A histological examination revealed a few Mott cells in the biopsy specimens taken from the new lesions. In turn, H. pylori eradication therapy was performed 1 month after the detection of the new lesions. One year after the eradication therapy, follow-up upper gastrointestinal endoscopy revealed that multiple lesions had almost disappeared, and the histological examination of the gastric biopsy specimens confirmed the disappearance of Mott cells. We herein report a case of Russell body gastritis in which multifocal lesions were observed after endoscopic submucosal dissection, and which was subsequently treated by H. pylori eradication therapy.