Russell Body Typhlitis: A Case Report and Literature Review.

Area of Science:

• Gastroenterology
• Pathology
• Immunology

Background:

• Russell bodies are intracytoplasmic immunoglobulin accumulations within plasma cells.
• Russell body colitis is an exceedingly rare condition, with only three prior cases documented in English literature.
• The pathogenesis and precise clinical significance of Russell bodies in the gastrointestinal tract remain incompletely understood.

Observation:

• A 78-year-old male patient with cirrhosis presented with prominent cecal infiltration by plasma cells containing Russell bodies.
• Histopathological examination revealed plasma cells without nuclear atypia or mitoses, and no evidence of light chain restriction.
• This case represents the fourth reported instance of Russell body colitis and is unique due to its localized cecal presentation.

Findings:

• The reported case is the first instance of localized Russell body typhlitis.
• The patient's condition occurred in the cecum, distinct from previously reported cases in the sigmoid colon, rectal adenoma, or diffuse gastrointestinal disease.
• An adjacent erosion, potentially linked to nonsteroidal anti-inflammatory drug (NSAID) use, may have contributed to Russell body formation in this cirrhotic patient.

Implications:

• This case expands the spectrum of Russell body colitis, highlighting its potential for localized presentation, specifically as typhlitis.
• The findings suggest that underlying conditions like cirrhosis and NSAID-associated erosions might predispose to the formation of Russell bodies in the gastrointestinal tract.
• Further research is warranted to elucidate the specific mechanisms and clinical implications of Russell body formation in localized gastrointestinal conditions.