Russell bodies in the pulp of a primary tooth

Localized accumulation of kappa restricted Russell body-containing plasma cells in tonsil

An abnormal clonal plasma cell proliferation with Russell bodies is rare in chronic inflammatory reactions in adult patients. We describe the first case of light chain restricted Russell body accumulation within germinal centers of lymphoid follicles of the tonsil in a child. This should not be confused with a neoplastic process.

Russell body apical periodontitis: an unusual case report

Russell bodies (RBs) changes in chronic apical lesions have rarely been reported in the literature. We describe a case of a periapical lesion abundantly and extensively composed of RB. Microscopic examination showed accumulation of plasma cells containing globular, spherical, polygonal, and eosinophilic structures against fibrous connective tissue. Initial diagnostic considerations based on a smaller magnification included hypersecretory plasmocytoma, although there was no evidence of infiltrative growth, mitotic activity, nuclear atypia, or cellular pleomorphism. Then, a panel of immunohistochemical markers was applied and the cells showed positivity with both kappa and lambda chains demonstrating their polyclonal origin. The extensive accumulation of RBs involving the periapical region represents an unreported and significant histologic change, as it was mimicking a malignant neoplasm.

Russell bodies in dental pulp of permanent human teeth

OBJECTIVES

We sought to characterize the prevalence of Russell bodies in specimens clinically diagnosed as pulpitis.

STUDY DESIGN

Forty-five teeth with symptomatic irreversible pulpitis were extracted, fixed, and demineralized. Five nonsymptomatic human teeth extracted for orthodontic purposes were used as controls. All teeth were then processed for light microscopy, for which they were stained variously, or for transmission electron microscopy (TEM).

RESULTS

There was no evidence of Russell bodies in the pulp of 5 nonsymptomatic human teeth. Russell bodies, however, were detected in 31/45 (69%) of pulpitis specimens examined by light microscopy. The basic stains safranin and fucsin gave better visualisation of them than other staining procedures. All pulpitis specimens were histologically characterized as having the features of chronic inflammation. Of 5 specimens of pulpitis teeth evaluated by TEM, all exhibited Russell bodies. There was no morphological distinction among the Russell bodies when view either by light or electron microscopy. These structures appeared either within rough endoplasmic reticulum (RER) or they were found in extracellular stroma, suggesting their association with the lysis of cells.

CONCLUSIONS

Russell bodies are prevalent in pulpitis samples with histological features of chronic inflammation, but are not found in all such samples. Russell bodies may not have been frequently detected in the past due to the types of stains employed in histolopathological study of pulps. The mechanistic basis of the association of Russell bodies with the symptoms of irreversible pulpitis is not clear.