Isolated Russell Body Duodenitis

Under the influence of an antigen, plasma cells produce immunoglobulins, which appear as eosinophilic globules on light microscopy. Sometimes, one or more of the cisterns of rough endoplasmic reticulum in plasma cells may become distended with these immunoglobulin-containing inclusions, termed Russell bodies, which were first described in 1890 by W. Russell [1]. These bodies are probably a result of disturbed secretion [2]. Mott cells are plasma cells containing multiple Russell bodies. Mott cells can be found in numerous settings, including: multiple myeloma, indolent lymphomas, and in the setting of chronic inflammation. Therefore, their presence alone is not indicative of malignancy. Russell body gastritis (RBG), a localized collection of polyclonal Russell bodies in the stomach, is an uncommon, yet well-reported entity that is often associated with Helicobacter pylori infection [3, 4]. It was first described in 1998 in Japan by Tazawa and Tsutsumi [3]. They reported a case of a 53-year-old male with a long-standing history of alcohol abuse who presented with epigastric pain. Gastric biopsy revealed numerous plasma cells distended with Russell bodies, giving the mucosa a characteristic histologic appearance. H. pylori-like organisms were also identified in the examined gastric biopsies. They concluded that the H. pylori infection likely caused the plasma cells to secrete immunoglobulin, forming Russell bodies. Subsequently, RBG has been described in other patients with alcohol abuse as well as human immunodeficiency virus (HIV) infection. Herein, we report a case of Russell body duodenitis (RBD) in an HIV-positive patient. Unique to our patient is the lack of concomitant RBG or H. pylori infection. Furthermore, in our review of the literature, no cases of isolated RBD have been reported to date