Dear Editor

I read with interest the recent report of two cases of ‘Russell body gastritis’ by Paik and colleagues.[1] The authors described the association of their cases with Helicobacter pylori infection, and proposed that chronic infection by this organism may have caused the overproduction of immunoglobulins by the plasma cells leading to the conspicuous Russell body formation. The original report of Russell body gastritis was also associated with Helicobacter infection,[2] as was a more recent additional case documented by Ensari and colleagues.[3] In contrast, the cases reported by Erbersdobler et al, and by Drut and Olenchuk, were negative for Helicobacter pylori.[4,5]

We recently documented a similar inflammatory process involving the uterine cervix in a 46-year female presenting with an abnormal screening Pap smear.[6] No specific infective organism was identified and the lesion appeared to resolve spontaneously in that follow up Pap smear and colposcopy were negative. A further example of non-gastric Russell body rich inflammation was described in a patient with Barrett’s oesophagus.[7] No organisms were documented in this patient. Therefore it would appear that not all cases of Russell body gastritis are associated with Helicobacter infection, and that Russell body-rich inflammatory infiltrates may involve mucosal sites other than the stomach. The significance of this unusual reactive process remains uncertain. Interestingly, one of the patients with Russell body gastritis was also HIV-positive,[5] but none of the other cases appears to have been associated with immunosuppression.

References

1. Paik S, Kim S-H, Kim J-H, Yang WI, Lee YC. Russell body gastritis associated with Helicobacter pylori infection: a case report. J Clin Pathol 2006; 59: 1316-9.

2. Tazawa K, Tsutsumi Y. Localised accumulation of Russell body-containing plasma cells in gastric mucosa with Helicobacter pylori infection: ‘Russell body gastritis’. Pathol Int 1998; 48: 242-4.

3. Ensari A, Savas B, Okcu Heper A, Kuzu I, Idilman R. An unusual presentation of Helicobacter pylori infection: so-called “Russell body gastritis’. Virchows Arch 2005; 446: 463-6.

4. Erbersdobler A, Petri S, Lock G. Russell body gastritis: an unusual, tumor-like lesion of the gastric mucosa. Arch Pathol Lab Med 2004; 128: 915-7.

5. Drut R, Olenchuk AB. Images in pathology. Russell body gastritis in an HIV-positive patient. Int J Surg Pathol 2006; 14: 141-2.

6. Stewart CJR, Leake R. Reactive plasmacytic infiltration with numerous Russell bodies involving the uterine cervix: ‘Russell body cervicitis’. Pathology 2006; 38: 177-9.

7. Rubio CA. Mott cell (Russell bodies) Barrett’s oesophagitis. In Vivo 2005; 19: 1097-1100.