A rare case of malignant lymphoma with Russell like bodies of the ileocecal region and its peritoneal cytologic findings.
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Peritoneal cytological findings of a rare case of malignant lymphoma with Russell like bodies of the ileocecal region was reported.<BR>A 64-year-old man was admitted to Hirata Municipal Hospital with complaints of constipation and colicky abdominal pain.Eight month later, operation was performed. Operative material showed a circumferential ulcerative tumor of the ileocecal region and metastasis to the hepatic flexure colon and regional lymph nodes.<BR>Histologically, diffuse and obscure nodular infiltration of mixture of medium and large sized lymphocytes were found transmurally and this tumor was thus identified to be malignant lymphoma, non-Hodgkin, diffuse, mixed cell type, according to LSG (lymphoma study group) classification.It was quite unusual that there were numerous cells which exhibited marginal located nuclei and Russell like bodies with abundunt eosinophilic globular inclusions in the cytoplasm among the usual lymphoma cells with occasional cleaved nuclei.Some of these cells with Russell like bodies had the same atypical nuclei as usual lymphoma cells had. The Russell like bodies were strongly positive for PAS stain (diastase resistant).By the immunohistochemical study using the Streptoavidin-Biotin method, the Russell like bodies revealed to be monoclonally stained with anti-IgM and anti-x.Many lymphoma cells with usual morphology were also positive with these antibodies monoclonally. These results indicate that the cells with Russell like bodies originated from lymphoma cells and produced IgM-k type immunoglobulin which led to the formation of Russell like bodies.<BR>One month after operation, Peritoneal effusion appeared and aspiration cytology was performed.Among scattered tumor cells, signet ring like cells consisted of core-like eosinophilic globular cytoplasm which was consistent with Russell like bodies and marginal located nuclei were mixed with cleaved and non-cleaved lymphocytes.In Giemsa stain, these cells also showed prominent nulcear irregularity and cytoplasmic vacuolar change.<BR>In this case, if no clinical information had be obtained, it would be difficult to diagnose them as malignant lymphoma cytologically.
- 特定非営利活動法人 日本臨床細胞学会の論文
特定非営利活動法人 日本臨床細胞学会 | 論文
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