Abstract
Crystal-storing histiocytosis (CSH) localized to the stomach is very rare, with only two cases reported to date. The present patient was a 55-year-old woman with no noteworthy symptoms. An area of discoloration was seen in the greater curvature of the gastric body on upper endoscopy by a local physician, and CSH was strongly suspected on biopsy examination. On upper endoscopy performed at our hospital, a flat, whitish, finely granular membrane with a diameter of 10 mm was seen in the greater curvature of the gastric body on white light observation. On magnifying endoscopy of the focal site, white granular material could be seen in the subepithelium, and the surface layer microvascular architecture image seen below the mucosal subepithelium was similar to the background, suggesting localization of the white material in a deep mucosal layer. On endoscopic ultrasound, this was depicted as multiple hyperechoic spots within the second layer corresponding to the involved area. Endoscopic submucosal dissection (ESD) was performed for a definitive diagnosis. Histopathological assessment of resected specimens revealed infiltration of abundant histiocytes including acidophilic crystalline structured material and positive plasma cells on anti-κ chain immunostaining, and CSH was diagnosed. Since this patient could have had a concomitant background autoimmune or hematologic disease, a systemic search was done. During this search, comorbid Sjögren’s syndrome was discovered. This case of asymptomatic Sjögren’s syndrome discovered during investigation of very rare gastric CHS is reported.
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Jones D, Bhatia VK, Krausz T, Pinkus GS. Crystal-storing histiocytosis: a disorder occurring in plasmacytic tumors expressing immunoglobulin kappa light chain. Hum Pathol. 1999;30:1441–8.
Lebeau A, Zeindl-Eberhart E, Müller EC, Müller-Höcker J, Jungblut PR, Emmerich B, et al. Generalized crystal-storing histiocytosis associated with monoclonal gammopathy: molecular analysis of a disorder with rapid clinical course and review of the literature. Blood. 2002;100:1817–27.
Ionescu DN, Pierson DM, Qing G, Li M, Colby TV, Leslie KO. Pulmonary crystal-storing histiocytoma. Arch Pathol Lab Med. 2005;129:1159–63.
Hirota S, Miyamoto M, Kasugai T, Kitamura Y, Morimura Y. Crystalline light-chain deposition and amyloidosis in the thyroid gland and kidneys of a patient with myeloma. Arch Pathol Lab Med. 1990;114:429–31.
Llobet M, Castro P, Barceló C, Trull JM, Campo E, Bernadó L. Massive crystal-storing histiocytosis associated with low-grade malignant B-cell lymphoma of MALT-type of the parotid gland. Diagn Cytopathol. 1997;17:148–52.
Stirling JW, Henderson DW, Rozenbilds MA, Skinner JM, Filipic M. Crystalloidal paraprotein deposits in the cornea: an ultrastructural study of two new cases with tubular crystalloids that contain IgG kappa light chains and IgG gamma heavy chains. Ultrastruct Pathol. 1997;21:337–44.
Papla B, Spólnik P, Rzenno E, Zduńczyk A, Rudzki Z, Okoń K, et al. Generalized crystal-storing histiocytosis as a presentation of multiple myeloma: a case with a possible pro-aggregation defect in the immunoglobulin heavy chain. Virchows Arch. 2004;445:83–9.
Bosman C, Camassei FD, Boldrini R, Piro FR, Saponara M, Romeo R, et al. Solitary crystal-storing histiocytosis of the tongue in a patient with rheumatoid arthritis and polyclonal hypergammaglobulinemia. Arch Pathol Lab Med. 1998;122:920–4.
Joo M, Kwak JE, Chang SH, Kim H, Chi JG, Moon YS, et al. Localized gastric crystal-storing histiocytosis. Histopathology. 2007;51:116–9.
Takahashi K, Naito M, Takatsuki K, Kono F, Chitose M, Ooshima S, et al. Multiple myeloma, IgA kappa type, accompanying crystal-storing histiocytosis and amyloidosis. Acta Pathol Jpn. 1987;37:141–54.
Dogan S, Barnes L, Cruz-Vetrano WP. Crystal-storing histiocytosis: report of a case, review of the literature (80 cases) and a proposed classification. Head Neck Pathol. 2012;6:111–20.
Ionescu DN, Pierson DM, Qing G, Li M, Colby TV, Leslie KO. Pulmonary crystal-storing histiocytoma. Arch Pathol Lab Med. 2005;129:1159–63.
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Yano, Y., Nagahama, T., Matsui, T. et al. Gastric crystal-storing histiocytosis detected with asymptomatic Sjögren’s syndrome: report of a case and summary. Clin J Gastroenterol 6, 237–242 (2013). https://doi.org/10.1007/s12328-013-0388-8
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DOI: https://doi.org/10.1007/s12328-013-0388-8