title: A case of mucosa-associated lymphoid tissue lymphoma of the gastrointestinal tract showing extensive plasma cell differentiation with prominent Russell bodies.
abstract: A 73-year-old Japanese woman was hospitalized for detailed examination of nausea, diarrhea and loss of appetite. Atypical erosion in the ileum was found on endoscopy. Biopsy of this erosion showed proliferation of cells containing numerous Russell bodies. Differential diagnoses considered were Russell body enteritis, crystal-storing histiocytosis, Mott cell tumor, immunoproliferative small intestinal disease (IPSID) and mucosa-associated lymphoid tissue (MALT) lymphoma. The cells containing prominent Russell bodies showed diffuse positivity for CD79a and CD138, but negative results for CD20, CD3, UCHL-1, CD38 and CD68. Russell bodies were diffusely positive for lambda light chain, but negative for kappa light chain, and immunoglobulin (Ig) G, IgA and IgM. Based on these findings, Russell body enteritis, crystal-storing histiocytosis and IPSID were ruled out. As the tumor formed no mass lesions and was restricted to the gastrointestinal tract, MALT lymphoma with extensive plasma cell differentiation was finally diagnosed. The patient showed an unexpectedly aggressive clinical course. The number of atypical lymphocytes in peripheral blood gradually increased and T-prolymphocytic leukemia (T-PLL) emerged. The patient died of T-PLL 7 mo after admission. Autopsy was not permitted.
authors.affiliation: Keita Kai, Masanori Masuda, Yukari Takase, Osamu Tokunaga, Departments of Pathology and Microbiology, Saga University Faculty of Medicine, Saga 849-8501, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Kai
authors.forename: Masaharu
authors.initials: M
authors.lastname: Miyahara
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Shinich
authors.initials: S
authors.lastname: Kido
authors.forename: Masanori
authors.initials: M
authors.lastname: Masuda
authors.forename: Yukari
authors.initials: Y
authors.lastname: Takase
authors.forename: Osamu
authors.initials: O
authors.lastname: Tokunaga
keywords: Mott cell tumor; Mucosa-associated lymphoid tissue lymphoma; Plasmacytoma; Russell body; T-prolymphocytic leukemia