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[PubMed] [Google Scholar] 3. a 6 cm very long Barrett’s mucosa. Microscopic examination of the biopsy revealed specialized columnar cell metaplasia, consistent with Barrett’s esophagus. Lamina propria showed extensive swelling with several monomorphic cells with eccentric nuclei and abundant eosinophilic ground-glass-like cytoplasm (Number 1). Immunohistochemistry exposed positive staining for CD79a and CD138, confirming the plasma cell phenotype of these cells. These cells were polyclonal and immunoreactive for both kappa and lambda light chains (Number 2). Cytokeratin AE1/AE3 was bad. The Barrett’s mucosa was bad for dysplasia. Conversation First explained by a Scottish physician Russell, the eponymously named Russell body are eosinophilic, large, immunoglobulin-containing inclusions that are commonly found within the cytoplasm of plasma cells. 1 Such plasma cells filled with RBs have also been called CL2 Linker Mott cells.2 Russell body gastritis (RBG) or gastroenteritis is a form of chronic gastrointestinal CL2 Linker mucosal swelling CL2 Linker containing plasma cells with prominent intracytoplasmic RBs. It is believed that CL2 Linker RBs are the result of cellular response to overstimulation of plasma cells in chronic swelling, which results in condensed immunoglobulin in dilated endoplasmic reticulum cisternae.2,3 The 1st case of RBG was described by Tazawa and Tsutsumi in 1998, which was associated with infection.4 Since then, several instances of RBG and rare cases of RB duodenitis have been reported.5 The first case of RBs CL2 Linker with Barrett’s esophagus was described by Rubio in 2005, and it was termed RB esophagitis.6 Bhaijee et al reported the second case of RBs associated with Barrett’s esophagus, which expanded the classic description of RBG and enteritis to esophagitis. 7 The pathogenesis of RBG still remains unfamiliar. An association with infection has been suggested.7,8 It is possible the chronic infection with may activate plasma-cell hyperactivation and subsequently lead to hyperproduction of immunoglobulins with numerous RB formation. The disappearance of RBs after the treatment of supports such a hypothesis. However, the getting of RBs in the absence of is not clearly recognized. The current case presents a unique situation in which RBs were observed in association with Barrett’s esophagus. A biopsy from your gastric antrum was bad for infection. Similarly, it is quite sensible to infer that illness is unlikely to play an etiologic part in the event of RBs in the establishing of Barrett’s esophagus. It has been suggested previously in the literature that immunocompromised status can predispose to the development of RBG.9 However, the current case was not known to have any associated immunocompromised condition. On the other hand, a chronic inflammatory state appears to be a common establishing between both the presence of RBs and intestinal metaplasia. Open in a separate window Number 1. Biopsy from your Barrett’s Rabbit Polyclonal to LASS4 mucosa showing abundant intracytoplasmic eosinophilic globules with eccentric nuclei in the lamina propria (hematoxylin and eosin stain, 40 magnification). Chronic swelling and injury are known to result in mucosal changes such as intestinal metaplasia and gastric mucosal atrophy, among others. It is plausible that plasma cells packed full of immunoglobulin-containing endoplasmic reticulum might have an inflammatory backdrop that can clarify both Barrett’s esophagus and the event of RBs. However, this can just become an incidental association and cannot be totally ruled out. Differential analysis remains demanding because clinically and microscopically it can be puzzled having a neoplastic process. The possibility of hematological malignancy, including plasmacytoma and mucosa-associated lymphoid cells lymphoma, should be ruled out. Signet ring cell carcinoma is definitely another important diagnostic consideration, which can be ruled out from the absence of nuclear atypia, cytomorphologic characteristics, and lack cytokeratin manifestation. The periodic acid-Schiff reaction can help determine RBs by conferring a dense, glassy stain to intracytoplasmic immunoglobulins. Plasma cell markers, such as CD138 and CD79a, are helpful, and coexpression of kappa and lambda light chain will demonstrate the polyclonal nature of the plasma cell infiltrate. Associated gastric carcinoma and infectious providers, such as and when the organism was found to be connected. For RB Barrett’s esophagus, where is an unlikely association, treatment should be aimed at managing Barrett’s esophagus, per recommended guidelines. We present this case to stress the importance of realizing this unusual entity. It also represents a potential diagnostic pitfall because the distended plasma cells may be mistaken for signet ring cells of gastric adenocarcinoma or low-grade lymphoma. Hence, an awareness of this entity is important to avoid diagnostic misunderstandings. DISCLOSURES Author contributions: P. Dhorajiya published the manuscript and is the article guarantor. R. Mannan edited and authorized the final manuscript. Financial disclosure:.