What are Dutcher bodies?

Dutcher Bodies: Definition and Significance

Dutcher bodies are aggregates of immunoglobulins in the nucleus of plasma cells or lymphoplasmacytoid cells 1.

Characteristics of Dutcher Bodies

• Dutcher bodies are periodic acid-Schiff (PAS)-positive intranuclear pseudoinclusions 2
• They appear as eosinophilic inclusions within the nucleus of plasma cells or lymphoplasmacytoid cells
• They represent immunoglobulin accumulation within the nucleus, specifically:
  • Most commonly composed of IgM kappa 3, 4
  • Often associated with J-chains 5
  • Can be visualized using PAS staining techniques 4

Clinical Significance and Disease Associations

Dutcher bodies are primarily associated with:

1. Lymphoplasmacytic lymphomas:

   • Most commonly seen in Waldenström macroglobulinemia 1
   • Present in approximately 50% of bone marrow samples from patients with lymphoplasmacytic lymphoma 1

2. Other B-cell neoplasms:

   • Marginal zone lymphomas, particularly MALT lymphomas 4
   • Multiple myeloma/plasmacytomas (approximately 22% of cases) 5
   • Follicular lymphoma (7.5-20% of cases) 5
   • Other B-cell lymphomas with plasmacytic differentiation 3

3. Rare occurrence in benign conditions:

   • Occasionally found in chronic inflammatory conditions like chronic synovitis 2
   • Not typically seen in reactive plasma cell proliferations

Diagnostic Value

• Dutcher bodies serve as an important morphological clue in the diagnosis of lymphoid neoplasms with plasmacytic differentiation
• Their presence can help distinguish MALT lymphoma from plasmacytoma in cytological specimens 4
• In lymphoplasmacytic lymphoma involving bone marrow, Dutcher bodies are a characteristic finding 1
• The intrafollicular distribution of cells containing Dutcher bodies may suggest follicular lymphoma 3

Differentiation from Other Inclusions

• Dutcher bodies should be distinguished from:
  • Russell bodies (cytoplasmic immunoglobulin inclusions)
  • Mott cells (plasma cells with multiple Russell bodies)
  • Crystalline inclusions in the cytoplasm 6

Pathophysiology

Dutcher bodies represent abnormal trafficking of immunoglobulin that becomes stored within the nucleus rather than being properly secreted. They are not limited to a specific B-cell lymphoma type but can occur in any immunoglobulin-producing B-cell neoplasm 5.

In summary, Dutcher bodies are nuclear immunoglobulin inclusions most commonly associated with lymphoplasmacytic lymphoma and other B-cell neoplasms with plasmacytic differentiation. Their identification through appropriate staining techniques provides valuable diagnostic information in the evaluation of lymphoproliferative disorders.