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Sarmiento AMA, Parulan MAA, Agbay RLMC. Rosai-Dorfman disease mimicking cavernous hemangioma: a case report. Orbit 2023; 42:612-616. [PMID: 35467463 DOI: 10.1080/01676830.2022.2055086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/12/2022] [Indexed: 10/18/2022]
Abstract
A 31-year-old female presented to the clinic with a 2 year history of proptosis of the right eye. She was diagnosed with cavernous hemangioma during her initial ophthalmologic consult and was advised monitoring. However, after a considerable increase in proptosis, she underwent an excision biopsy of the right orbital mass. A diagnosis of Rosai Dorfman disease was made after the histopathology report revealed a fibrosclerotic tissue with histiocytic proliferation showing emperipolesis that is mixed with numerous small lymphocytes and plasma cells. Rosai Dorfman disease is a rare disease presenting with lymphadenopathy and sinus histiocytosis. Orbital involvement can be the principal manifestation with proptosis as the most common presentation. Resection of the orbital lesion helped in the resolution of the mild ophthalmic symptoms but since the disease has other systemic associations, a complete systemic workup should be done to monitor recurrence.
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Affiliation(s)
| | | | - Rose Lou Marie C Agbay
- Department of Laboratory Medicine and Pathology, The Medical City, Pasig City, Philippines
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52
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Rajabi MT, Amoli FA, Koochakzadeh L, Rafizadeh SM, Rajabi MB, Hosseini SS, Aghajani AH, Pezeshgi S, Aghdam MA, Farrokhpour H, Abla O, Sadeghi R. Orbital histiocytosis and fibrohistiocytosis: the clinicopathological characteristics of 117 patients, over a decade of experience. Int Ophthalmol 2023; 43:4997-5009. [PMID: 37840073 DOI: 10.1007/s10792-023-02903-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE To describe the clinicopathological features of a large cohort of patients with orbital histiocytoses and fibrohistiocytosis, such as Langerhans cell histiocytosis (LCH) and non-LCH disorders, and correlate patients' clinical characteristics with their pathological diagnosis. METHODS In this retrospective study, medical records of patients presenting to Farabi Eye Hospital, a tertiary eye care center in Tehran, Iran, from 2010 until 2022, were reviewed. Patients' demographics, chief complaint, location and laterality of the tumor, best-corrected visual acuity, presence of bone erosion on imaging, and their pathological diagnosis were retrieved. Excisional biopsy was performed and evaluated through light microscopy and immunohistochemistry study for their respective markers, including CD1a, CD68, CD207, and S100. RESULTS A total of 117 patients with 11 pathological subtypes of histiocytoses and fibrohistiocyosis were identified, with 56.4% male and 43.6% female patients. The mean age at presentation was 23.4 years (range 1.5 months-73 years). Swelling and palpable mass were the most common chief complaints. LCH was the most common pathology (32.5%), followed by juvenile xanthogranuloma (26.5%) and adult xanthogranuloma (21.4%). Age, lesion location, and bone erosion had a statistically significant difference among the various diagnosed subtypes. CONCLUSIONS Histiocytoses and fibrohistiocytosis are diverse and rare disorders potentially involving multiple organ systems. Ophthalmic manifestations of these diseases are even more uncommon. We reviewed their orbital presentation along with their respective histopathological findings. Our results also suggested that an orbital CT scan can be of diagnostic value to discriminate LCH from other histiocytic pathologies.
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Affiliation(s)
- Mohammad Taher Rajabi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Fahimeh Asadi Amoli
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Leili Koochakzadeh
- Department of Pediatric Hematology and Oncology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Rafizadeh
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Mohammad Bagher Rajabi
- Eye Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir Hossein Aghajani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Saharnaz Pezeshgi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Abdolahzadeh Aghdam
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Hossein Farrokhpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Oussama Abla
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Reza Sadeghi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, 1336616351, Iran.
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53
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Asiri LM, Alghamdi AM, Alzidani T, Rebai R. Hints to Diagnose Intracranial Rosai-Dorfman Disease: A Case Report and Literature Review of Cases in Saudi Arabia. Cureus 2023; 15:e51204. [PMID: 38283458 PMCID: PMC10818094 DOI: 10.7759/cureus.51204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Rosai-Dorfman disease (RDD) was recognized as a distinct clinical entity by Rosai and Dorfman in 1969. It is a rare histiocytic proliferative disorder that occurs in various locations and occasionally involves the central nervous system. In this article, we aim to describe a case of intracranial RDD and to provide a review of the literature on intracranial RDD in Saudi Arabia. A 37-year-old woman presented with a history of generalized seizures. Physical examination disclosed bilateral cervical lymphadenopathy with no neurological deficit. Brain magnetic resonance imaging (MRI) demonstrated an extra-axial, homogenous, Gadolinium-enhancing, space-occupying lesion with extensive dural involvement. The patient was successfully treated by total surgical resection. Postoperatively, the patient did not receive any adjuvant therapy. Biopsy with immunohistochemical analysis confirmed the diagnosis of intracranial RDD. On follow-up examination, six months later, there was no recurrence of the lesion. A preoperative diagnosis of intracranial RDD is challenging since its MRI appearance can be similar to other intracranial diseases. Herein, we discussed some neuroradiographic findings that might help distinguish RDD from other intracranial diseases.
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Affiliation(s)
- Lina M Asiri
- College of Medicine, Qassim University, Buraydah, SAU
| | - Abdulaziz M Alghamdi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Turki Alzidani
- Neurological Surgery, King Faisal Medical Complex, Taif, SAU
| | - Riadh Rebai
- Neurological Surgery, King Fahad General Hospital, Jeddah, SAU
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54
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Shiloh R, Lubin R, David O, Geron I, Okon E, Hazan I, Zaliova M, Amarilyo G, Birger Y, Borovitz Y, Brik D, Broides A, Cohen-Kedar S, Harel L, Kristal E, Kozlova D, Ling G, Shapira Rootman M, Shefer Averbuch N, Spielman S, Trka J, Izraeli S, Yona S, Elitzur S. Loss of function of ENT3 drives histiocytosis and inflammation through TLR-MAPK signaling. Blood 2023; 142:1740-1751. [PMID: 37738562 DOI: 10.1182/blood.2023020714] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/11/2023] [Accepted: 08/24/2023] [Indexed: 09/24/2023] Open
Abstract
Histiocytoses are inflammatory myeloid neoplasms often driven by somatic activating mutations in mitogen-activated protein kinase (MAPK) cascade genes. H syndrome is an inflammatory genetic disorder caused by germ line loss-of-function mutations in SLC29A3, encoding the lysosomal equilibrative nucleoside transporter 3 (ENT3). Patients with H syndrome are predisposed to develop histiocytosis, yet the mechanism is unclear. Here, through phenotypic, molecular, and functional analysis of primary cells from a cohort of patients with H syndrome, we reveal the molecular pathway leading to histiocytosis and inflammation in this genetic disorder. We show that loss of function of ENT3 activates nucleoside-sensing toll-like receptors (TLR) and downstream MAPK signaling, inducing cytokine secretion and inflammation. Importantly, MEK inhibitor therapy led to resolution of histiocytosis and inflammation in a patient with H syndrome. These results demonstrate a yet-unrecognized link between a defect in a lysosomal transporter and pathological activation of MAPK signaling, establishing a novel pathway leading to histiocytosis and inflammation.
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Affiliation(s)
- Ruth Shiloh
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petach Tikva, Israel
- Felsenstein Medical Research Center, Faculty of Medicine, Tel Aviv University, Petach Tikva, Israel
| | - Ruth Lubin
- The Institute of Biomedical and Oral Research, Hebrew University, Jerusalem, Israel
| | - Odeya David
- Pediatric Endocrinology Unit, Soroka University Medical Center, Beer Sheva, Israel
- Pediatric Ambulatory Center, Soroka University Medical Center, Beer Sheva, Israel
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Ifat Geron
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petach Tikva, Israel
- Felsenstein Medical Research Center, Faculty of Medicine, Tel Aviv University, Petach Tikva, Israel
| | - Elimelech Okon
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Idit Hazan
- The Institute of Biomedical and Oral Research, Hebrew University, Jerusalem, Israel
| | - Marketa Zaliova
- Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, Second Faculty of Medicine of Charles University Prague and University Hospital Motol, Prague, Czech Republic
| | - Gil Amarilyo
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petach Tikva, Israel
| | - Yehudit Birger
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petach Tikva, Israel
- Felsenstein Medical Research Center, Faculty of Medicine, Tel Aviv University, Petach Tikva, Israel
| | - Yael Borovitz
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Nephrology, Schneider Children's Medical Center, Petach Tikva, Israel
| | - Dafna Brik
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petach Tikva, Israel
| | - Arnon Broides
- Pediatric Ambulatory Center, Soroka University Medical Center, Beer Sheva, Israel
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Immunology Clinic, Soroka University Medical Center, Beer Sheva, Israel
| | - Sarit Cohen-Kedar
- Felsenstein Medical Research Center, Faculty of Medicine, Tel Aviv University, Petach Tikva, Israel
- Division of Gastroenterology, Rabin Medical Center, Petach Tikva, Israel
| | - Liora Harel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petach Tikva, Israel
| | - Eyal Kristal
- Pediatric Ambulatory Center, Soroka University Medical Center, Beer Sheva, Israel
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Immunology Clinic, Soroka University Medical Center, Beer Sheva, Israel
| | - Daria Kozlova
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pathology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
| | - Galina Ling
- Pediatric Ambulatory Center, Soroka University Medical Center, Beer Sheva, Israel
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | | | - Noa Shefer Averbuch
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Genetics Clinic, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- The Jesse and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Shiri Spielman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pediatrics A, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Jan Trka
- Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, Second Faculty of Medicine of Charles University Prague and University Hospital Motol, Prague, Czech Republic
| | - Shai Izraeli
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petach Tikva, Israel
- Felsenstein Medical Research Center, Faculty of Medicine, Tel Aviv University, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Beckman Research Institute, City of Hope, Duarte, CA
| | - Simon Yona
- The Institute of Biomedical and Oral Research, Hebrew University, Jerusalem, Israel
| | - Sarah Elitzur
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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55
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Chi SN, Yi JS, Williams PM, Roy-Chowdhuri S, Patton DR, Coffey BD, Reid JM, Piao J, Saguilig L, Alonzo TA, Berg SL, Ramirez NC, Jaju A, Mhlanga JC, Fox E, Hawkins DS, Mooney MM, Takebe N, Tricoli JV, Janeway KA, Seibel NL, Parsons DW. Tazemetostat for tumors harboring SMARCB1/SMARCA4 or EZH2 alterations: results from NCI-COG pediatric MATCH APEC1621C. J Natl Cancer Inst 2023; 115:1355-1363. [PMID: 37228094 PMCID: PMC11009504 DOI: 10.1093/jnci/djad085] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND National Cancer Institute-Children's Oncology Group Pediatric Molecular Analysis for Therapy Choice assigns patients aged 1-21 years with refractory solid tumors, brain tumors, lymphomas, and histiocytic disorders to phase II trials of molecularly targeted therapies based on detection of predefined genetic alterations. Patients whose tumors harbored EZH2 mutations or loss of SMARCB1 or SMARCA4 by immunohistochemistry were treated with EZH2 inhibitor tazemetostat. METHODS Patients received tazemetostat for 28-day cycles until disease progression or intolerable toxicity (max 26 cycles). The primary endpoint was objective response rate; secondary endpoints included progression-free survival and tolerability of tazemetostat. RESULTS Twenty patients (median age = 5 years) enrolled, all evaluable for response and toxicities. The most frequent diagnoses were atypical teratoid rhabdoid tumor (n = 8) and malignant rhabdoid tumor (n = 4). Actionable alterations consisted of SMARCB1 loss (n = 16), EZH2 mutation (n = 3), and SMARCA4 loss (n = 1). One objective response was observed in a patient with non-Langerhans cell histiocytosis with SMARCA4 loss (26 cycles, 1200 mg/m2/dose twice daily). Four patients with SMARCB1 loss had a best response of stable disease: epithelioid sarcoma (n = 2), atypical teratoid rhabdoid tumor (n = 1), and renal medullary carcinoma (n = 1). Six-month progression-free survival was 35% (95% confidence interval [CI] = 15.7% to 55.2%) and 6-month overall survival was 45% (95% CI = 23.1% to 64.7%). Treatment-related adverse events were consistent with prior tazemetostat reports. CONCLUSIONS Although tazemetostat did not meet its primary efficacy endpoint in this population of refractory pediatric tumors (objective response rate = 5%, 90% CI = 1% to 20%), 25% of patients with multiple histologic diagnoses experienced prolonged stable disease of 6 months and over (range = 9-26 cycles), suggesting a potential effect of tazemetostat on disease stabilization.
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Affiliation(s)
- Susan N Chi
- Department of Pediatrics, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Joanna S Yi
- Department of Pediatrics, Texas Children’s Cancer and Hematology Center, Baylor College of Medicine, Houston, TX, USA
| | - P Mickey Williams
- Molecular Characterization Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Sinchita Roy-Chowdhuri
- Department of Pathology and Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David R Patton
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Brent D Coffey
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joel M Reid
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - Jin Piao
- Department of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lauren Saguilig
- Children’s Oncology Group Statistical Center, Monrovia, CA, USA
| | - Todd A Alonzo
- Department of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Stacey L Berg
- Department of Pediatrics, Texas Children’s Cancer and Hematology Center, Baylor College of Medicine, Houston, TX, USA
| | - Nilsa C Ramirez
- Biopathology Center, Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - Alok Jaju
- Department of Radiology, Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | - Joyce C Mhlanga
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Elizabeth Fox
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - Douglas S Hawkins
- Department of Hematology-Oncology, Seattle Children’s Hospital, University of Washington, Seattle, WA, USA
| | - Margaret M Mooney
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Cancer Therapy Evaluation Program, Bethesda, MD, USA
| | - Naoko Takebe
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Cancer Therapy Evaluation Program, Bethesda, MD, USA
| | - James V Tricoli
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, USA
| | - Katherine A Janeway
- Department of Pediatrics, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Nita L Seibel
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Cancer Therapy Evaluation Program, Bethesda, MD, USA
| | - D Williams Parsons
- Department of Pediatrics, Texas Children’s Cancer and Hematology Center, Baylor College of Medicine, Houston, TX, USA
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56
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Acosta-Medina AA, Abeykoon JP, Go RS, Goyal G, Ravindran A, Schram SM, Rech KL. BRAF testing modalities in histiocytic disorders: Comparative analysis and proposed testing algorithm. Am J Clin Pathol 2023; 160:483-489. [PMID: 37458275 DOI: 10.1093/ajcp/aqad076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 06/01/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Understanding of histiocytic disorders has been revolutionized by demonstration of mitogen-activated protein kinase (MAPK) pathway mutations, most commonly BRAFV600E. The optimal testing strategy to assess BRAFV600E is unknown. We aimed to compare performance of testing modalities, to propose a framework for evaluation of BRAFV600E mutation status in histiocytic disorders. METHODS We retrospectively reviewed patients with histiocytic disorders and BRAF mutation testing on a lesional tissue specimen. RESULTS In 120 patients, BRAF assessment included immunohistochemistry (IHC) in 97 (80.2%), polymerase chain reaction (PCR) in 35 (28.9%), and next-generation sequencing (NGS) in 62 (51.2%). Forty-five underwent both NGS and IHC. With NGS as the gold standard, the sensitivity and specificity of IHC were 82.4% and 96.4%. Three false negatives were observed in biopsy specimens with low BRAFV600E variant allele frequency or decalcified tissue. One false-positive IHC was observed in a lung biopsy specimen, likely due to antibody cross-reactivity with respiratory cilia. Among 14 with successful NGS and PCR, a single discordance was observed. Two PCR-to-IHC discrepancies were observed, including one other false-positive IHC. CONCLUSIONS Immunohistochemistry was highly specific for detection of BRAFV600E. Main caveats were false negatives and lack of detection of non-BRAFV600E mutations. We propose the use of IHC as initial screening in general practice with reflex molecular testing if negative.
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Affiliation(s)
| | | | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, MN, US
| | - Gaurav Goyal
- Division of Hematology-Oncology and University of Alabama at Birmingham, Birmingham, AL, US
| | - Aishwarya Ravindran
- Division of Laboratory Medicine, University of Alabama at Birmingham, Birmingham, AL, US
| | | | - Karen L Rech
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, US
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Lv C, Zhong L, Wang Z, Zhao L. Whole-exome sequencing identified the mutation of IRF5 in thymic Rosai-Dorfman disease: A case report. Asian J Surg 2023; 46:5055-5057. [PMID: 37422400 DOI: 10.1016/j.asjsur.2023.06.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/15/2023] [Indexed: 07/10/2023] Open
Affiliation(s)
- Changsheng Lv
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lin Zhong
- Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhaoxuan Wang
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
| | - Lei Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
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58
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Hur K, Hong JY, Kim KH, Jeon J, Lee C, Kwak Y, Kim TM, Mun JH. Facial Cutaneous Rosai-Dorfman Disease: Dermoscopic Findings with Successful Surgical Treatment. Ann Dermatol 2023; 35:S287-S291. [PMID: 38061723 PMCID: PMC10727868 DOI: 10.5021/ad.22.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/17/2022] [Accepted: 05/24/2022] [Indexed: 12/20/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytosis characterized by an accumulation of activated histiocytes within the affected tissues. It is a heterogeneous disease that includes the classical (nodal) and extra-nodal variants. The cutaneous form of the disease without the characteristic lymphadenopathy is rare and is often misdiagnosed as other dermatologic diseases. Misdiagnosis as lymphoproliferative and infectious diseases such as lymphoma and tuberculosis have been reported in the literature. Herein, we report a case of facial cutaneous RDD with successful surgical treatment. In addition, we provide dermoscopic findings and literature review as dermoscopy can be a useful adjuvant tool in the diagnosis of cutaneous RDD.
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Affiliation(s)
- Keunyoung Hur
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea
| | - Ji Yeon Hong
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea
| | - Kyu Han Kim
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea
| | - Jihui Jeon
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Cheol Lee
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
| | - Yoonjin Kwak
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Cancer Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea.
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59
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Fernández Romero C, Gimeno Carpio E, Puglia Santos VC. Recent-Onset Indurated Plaque on the Mons Pubis. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:907-908. [PMID: 37343819 DOI: 10.1016/j.ad.2022.07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/19/2022] [Accepted: 07/06/2022] [Indexed: 06/23/2023] Open
Affiliation(s)
| | - E Gimeno Carpio
- Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, España
| | - V C Puglia Santos
- Servicio de Anatomía Patológica, Hospital Arnau de Vilanova, Valencia, España
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60
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Fernández Romero C, Gimeno Carpio E, Puglia Santos VC. [Translated article] Recent-Onset Indurated Plaque on the Mons Pubis. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T907-T908. [PMID: 37734546 DOI: 10.1016/j.ad.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/19/2022] [Accepted: 07/06/2022] [Indexed: 09/23/2023] Open
Affiliation(s)
| | - E Gimeno Carpio
- Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, Spain
| | - V C Puglia Santos
- Servicio de Anatomía Patológica, Hospital Arnau de Vilanova, Valencia, Spain
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61
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Chang L, Qiao B, Cai H, Lin H, Duan MH, Li J, Zhou DB, Goyal G, Sun CY, Cao XX. Clinical phenotypes, molecular analysis, and outcomes of patients with Rosai-Dorfman disease. Leukemia 2023; 37:2297-2300. [PMID: 37731024 DOI: 10.1038/s41375-023-02032-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/16/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Affiliation(s)
- Long Chang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China
| | - Bing Qiao
- Insititute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Cai
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China
| | - He Lin
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China
| | - Ming-Hui Duan
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China
| | - Jian Li
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China
| | - Dao-Bin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China
| | - Gaurav Goyal
- Division of Hematology-Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Chun-Yan Sun
- Insititute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Xin-Xin Cao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China.
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62
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Auerbach A, Aguilera NS. The changing landscape of pediatric histiocytoses: Birth, life, and transdifferentiation of pediatric histiocytes. Semin Diagn Pathol 2023; 40:420-428. [PMID: 37258365 DOI: 10.1053/j.semdp.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/19/2023] [Indexed: 06/02/2023]
Abstract
Histiocytic neoplasms in the children are very rare, and histiocytoses can occur in the perinatal period. The presumed origins and presentation of specific histiocytoses in the pediatric age group are described. Common and newly described histiocytoses are presented including Langerhans cell histiocytosis, Rosai-Dorfman disease, histiocytic sarcoma, ALK positive histiocytosis, and hemophagocytic lymphohistiocytosis. Molecular findings common to pediatric histiocytoses are also discussed.
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Affiliation(s)
- Aaron Auerbach
- Joint Pathology Center, Silver Spring, MD, United States of America
| | - Nadine S Aguilera
- University of Virginia Health System, Charlottesville, VA, United States of America.
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63
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Liu TY, Lo Y. Bruise-Like Subcutaneous Nodule at Buttock. Indian J Dermatol 2023; 68:721-722. [PMID: 38371573 PMCID: PMC10869006 DOI: 10.4103/ijd.ijd_91_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Affiliation(s)
- Tzu-Yu Liu
- From the Department of Dermatology, Cathay General Hospital, Taipei, Taiwan
| | - Yang Lo
- From the Department of Dermatology, Cathay General Hospital, Taipei, Taiwan
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64
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Wang Q, Bradley K, Zhang M, Li S, Li X. Rosai-Dorfman disease of the breast: a clinicoradiologic and pathologic study. Hum Pathol 2023; 141:30-42. [PMID: 37673345 DOI: 10.1016/j.humpath.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/26/2023] [Accepted: 08/31/2023] [Indexed: 09/08/2023]
Abstract
Rosai-Dorfman disease (RDD) is an uncommon histiocytic disorder typically involving lymph nodes and less frequently extranodal tissues. RDD involving the breast is rare and may clinically and radiologically mimic neoplastic and non-neoplastic disorders. We report seven patients with breast RDD, describe their clinicoradiologic and pathologic features, and discuss the differential diagnosis. Patients, ranging from 15 to 74 years of age, presented with unilateral and unifocal (5/7) or bilateral and multifocal (2/7) masses. RDD was either confined to the breast (6/7) or concurrently involved a lymph node (1/7). Masses ranged from 8 to 31 mm, categorized as Breast Imaging-Reporting and Data System (BI-RADS) 4 (6/7) or 5 (1/7). All cases showed similar morphology with many large histiocytes displaying emperipolesis with associated fibrosis and dense lymphoplasmacytic infiltrate. The abnormal histiocytes co-expressed CD68/CD163, S100, OCT2, and Cyclin D1 (7/7), and were negative for CK AE1/AE3 (7/7), CD1a (7/7), and BRAF V600E (6/6). Flow cytometry (n = 3), kappa/lambda in situ hybridization (n = 5), and IgG4/IgG immunohistochemistry (n = 1) did not reveal lymphoma or IgG4-related disease. No mycobacterial or fungal organisms were identified on acid-fast bacillus (AFB) and Grocott methenamine silver (GMS) stains (n = 5). Three patients underwent complete excision and none recurred or progressed to systemic disease during follow-up (88-151 months). In summary, breast RDD should be included in the differential diagnosis of a mass-forming breast lesion. Histopathology with ancillary studies and clinicoradiologic correlation is essential for accurate diagnosis and optimal clinical management. Patients with RDD of the breast have an excellent prognosis after complete excision.
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Affiliation(s)
- Qun Wang
- Department of Pathology, Emory University School of Medicine, Atlanta, GA, 30322, USA.
| | - Kyle Bradley
- Department of Pathology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Meng Zhang
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Shiyong Li
- Department of Pathology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Xiaoxian Li
- Department of Pathology, Emory University School of Medicine, Atlanta, GA, 30322, USA.
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65
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Rao X, Kang Z, Chen J, Cai C, Wang B, Zhang Q. Cervical spine Rosai-Dorfman disease: A case report and literature review. Medicine (Baltimore) 2023; 102:e35654. [PMID: 37904362 PMCID: PMC10615454 DOI: 10.1097/md.0000000000035654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 09/25/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Rosai-Dorfman disease is a benign lymphatic tissue proliferative disease with slow growth and is rarely observed in the clinic. Most of these patients present clinically with enlarged lymph nodes. In patients with spinal extranodal Rosai-Dorfman disease, which is even rare than the disease of lymph nodes, patients may experience numbness and weakness in the extremities. CASE PRESENTATION We report a 32-year-old male patient with multi-segmental spinal Rosai-Dorfman disease. On admission, his left fingers had been numb for 2 months. Over a 2-month period, the limb numbness progressed from the left to the right hand. The patient underwent resection of the lesion and internal fixation of the C2-C7 spine. The postoperative outcomes were satisfied and no recurrence was observed at 1-year follow-up. CONCLUSION Spinal Rosai-Dorfman disease is a relatively rare tumor of which the pathogenesis is still unclear, and most patients have no specific clinical manifestations. Characteristic imaging findings can indicate this disease, however, a definitive diagnosis still depends on a pathological examination. Currently, total surgical resection of the tumor is a relatively effective and preferred treatment.
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Affiliation(s)
- Xianfeng Rao
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Clinical College of Shantou University Medical College, Shenzhen, China
| | - Zhengwen Kang
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Clinical College of Shantou University Medical College, Shenzhen, China
| | - Jianwei Chen
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Clinical College of Shantou University Medical College, Shenzhen, China
| | - Chang Cai
- Department of Pathology, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Shenzhen, China
| | - Bo Wang
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Clinical College of Shantou University Medical College, Shenzhen, China
| | - Qiusheng Zhang
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Clinical College of Shantou University Medical College, Shenzhen, China
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66
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Riancho JA, Hernández JL, González-Vela C, López-Sundh AE, González-Lopez MA, Gomez de la Fuente F, Quirce R, Diamond EL. Erdheim-Chester Disease Due to a Novel Internal Duplication of NRAS: Response to Targeted Therapy with Cobimetinib. Int J Mol Sci 2023; 24:15467. [PMID: 37895147 PMCID: PMC10606995 DOI: 10.3390/ijms242015467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/08/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Histiocytoses encompass a group of exceptionally rare disorders characterized by the abnormal infiltration of tissues by histocytes. Among these, Erdheim-Chester disease (ECD) stands out as a multisystem histiocytosis that typically affects bones and various other tissues. Historically, the treatment of ECD has been challenging. However, recent breakthroughs in our understanding, particularly the discovery of somatic mutations in the RAS-MAPK pathway, have opened new opportunities for targeted therapy in a significant subset of patients with ECD and other histiocytoses. In this report, we present the case of a patient with ECD harboring a previously unidentified microduplication in the NRAS gene in a small fraction of skin cells. This discovery played a pivotal role in tailoring an effective therapeutic approach involving kinase inhibitors downstream of NRAS. This case underscores the crucial role of deep sequencing of tissue samples in ECD, enabling the delivery of personalized targeted therapy to patients.
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Affiliation(s)
- José A. Riancho
- Servicio de Medicina Interna, Hospital U.M. Valdecilla, Universidad de Cantabria, IDIVAL, CIBERER, 39008 Santander, Spain;
| | - José L. Hernández
- Servicio de Medicina Interna, Hospital U.M. Valdecilla, Universidad de Cantabria, IDIVAL, CIBERER, 39008 Santander, Spain;
| | - Carmen González-Vela
- Servicio de Anatomía Patológica, Hospital U.M. Valdecilla, Universidad de Cantabria, IDIVAL, 39008 Santander, Spain
| | - Ana E. López-Sundh
- Servicio de Dermatología, Hospital U.M. Valdecilla, Universidad de Cantabria, IDIVAL, 39008 Santander, Spain; (A.E.L.-S.); (M.A.G.-L.)
| | - Marcos A. González-Lopez
- Servicio de Dermatología, Hospital U.M. Valdecilla, Universidad de Cantabria, IDIVAL, 39008 Santander, Spain; (A.E.L.-S.); (M.A.G.-L.)
| | - Francisco Gomez de la Fuente
- Servicio de Medicina Nuclear, Hospital U.M. Valdecilla, Universidad de Cantabria, IDIVAL, 39008 Santander, Spain; (F.G.d.l.F.); (R.Q.)
| | - Remedios Quirce
- Servicio de Medicina Nuclear, Hospital U.M. Valdecilla, Universidad de Cantabria, IDIVAL, 39008 Santander, Spain; (F.G.d.l.F.); (R.Q.)
| | - Eli L. Diamond
- Departments of Neurology and Medicine, Memorial Sloan Kettering Center, New York, NY 10065, USA;
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67
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Zainal Abidin MR, Tuang GJ, Mansor M. Letter to the Editor: "Rosai Dorfman: Rare Cause of Cervical Lymphadenopathy". EAR, NOSE & THROAT JOURNAL 2023:1455613231205538. [PMID: 37843046 DOI: 10.1177/01455613231205538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
We read with great interest the article by Kobayashi KE et al. published in 2023 entitled: "Presentation of external ear Rosai-Dorfman disease with laryngeal involvement" and wish to reconnoiter Rosai-Dorfman Disease's (RDD) clinical entities and the possible implications from the perspective of otology.
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Affiliation(s)
- Muhammad Raziin Zainal Abidin
- Department of Otolaryngology, Head and Neck Surgery, Hospital Al-Sultan Abdullah Universiti Teknologi MARA (UiTM), Puncak Alam, Selangor, Malaysia
| | - Geng Ju Tuang
- Department of Otolaryngology, Head and Neck Surgery, Hospital Al-Sultan Abdullah Universiti Teknologi MARA (UiTM), Puncak Alam, Selangor, Malaysia
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | - Masaany Mansor
- Department of Otolaryngology, Head and Neck Surgery, Hospital Al-Sultan Abdullah Universiti Teknologi MARA (UiTM), Puncak Alam, Selangor, Malaysia
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
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68
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Liu Q, Liao F, Liu Y, Cheng Y, Qi C. Primary unifocal thymic Rosai-Dorfman disease: an extremely rare challenge in diagnostic practice. J Cardiothorac Surg 2023; 18:284. [PMID: 37817188 PMCID: PMC10566069 DOI: 10.1186/s13019-023-02381-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/30/2023] [Indexed: 10/12/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is currently considered a group of neoplastic diseases of unknown etiology, with monoclonal proliferation of histiocytes, showing unique histopathologic features and varying clinical presentation. Primary thymic RDD is an extremely rare extranodal form of this disorder. In this study, we describe the case of an otherwise healthy 64-year-old Chinese man who presented with an isolated, asymptomatic soft tissue density lesion in the anterior mediastinum detected by computed tomography. Histology of the surgical specimen revealed infiltration of thymic tissue by sheets of large histiocytes with mixed lymphocytes and plasma cells, and background fibrosis. Immunohistochemical staining of the histiocytes was positive for S100, CD68, CD163, OCT2 and cyclin D1, but negative for CD1a and BrafV600E expression, thus supporting a diagnosis of RDD. Primary thymic RDD is extremely rare and may be a diagnostic challenge when presenting as mediastinal lesion.
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Affiliation(s)
- Qian Liu
- Department of Pathology, Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College, No. 152, Aiguo Road, Nanchang, 330006, China
| | - Fengxiang Liao
- Department of Nuclear medicine, Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Yong Liu
- Department of Pathology, Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College, No. 152, Aiguo Road, Nanchang, 330006, China
| | - Yang Cheng
- Department of Pathology, Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College, No. 152, Aiguo Road, Nanchang, 330006, China
| | - Chubo Qi
- Department of Pathology, Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College, No. 152, Aiguo Road, Nanchang, 330006, China.
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69
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Foster CR, Reith JD, Habeeb O. Primary Bilateral Intraosseous Rosai-Dorfman Disease. Int J Surg Pathol 2023; 31:1347-1351. [PMID: 36474405 DOI: 10.1177/10668969221142042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disease of unknown etiology. Typically presenting with cervical adenopathy and constitutional symptoms, RDD involves bone in less than 10% of cases-and rarely presents as a primary intraosseous lesion. In this report, we describe the presentation of primary, bilateral intraosseous RDD, the first known case in the literature. Asymmetrically involving the lateral femoral condyles of a 59-year-old male, the lesion was discovered incidentally during evaluation and workup for giant cell tumor of bone involving the left tibia. Confirmation of the diagnosis required multiple biopsies and extensive evaluation-reflecting the diagnostic challenge associated with this case. We discuss the clinical, radiological, and pathological findings that allowed us to establish the diagnosis-as well as key differential diagnostic considerations and clinical outcome to date.
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Affiliation(s)
| | - John D Reith
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Omar Habeeb
- Histopathology Department, Middlemore Hospital, Auckland, New Zealand
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70
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Razanamahery J, Godot A, Leguy-Seguin V, Samson M, Audia S, Bonnotte B. Impact of BRAFV600E mutation on aggressiveness and outcomes in adult clonal histiocytosis. Front Immunol 2023; 14:1260193. [PMID: 37809108 PMCID: PMC10556468 DOI: 10.3389/fimmu.2023.1260193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Histiocytoses encompass a wide spectrum of diseases, all characterized by tissue infiltration by CD68+ histiocytes. Most adult histiocytoses are considered clonal diseases because they highlight recurrent somatic mutations in the MAP-kinase pathway gene, primarily BRAF. The presence of BRAF mutation is associated with widespread disease in children with Langerhans cell histiocytosis (LCH) or cardiovascular/neurological involvement in Erdheim-Chester disease (ECD). Nevertheless, few data are available on adult clonal histiocytosis. This is why we have conducted a retrospective study of all patients with clonal histiocytosis in our institution and present the data according to the presence of BRAF mutation. Among 27 adult patients (10 ECD, 10 LCH, 5 Rosai-Dorfman disease (RDD), and 3 mixed ECD/LCH), 11 (39%) have BRAF mutation with gain of function (n = 9) and deletion (n = 2). Those patients had frequent multicentric disease with risk organ involvement, especially the brain and cardiovascular system. They had frequent associated myeloid neoplasms (mostly chronic myelomonocytic leukemia) and received more frequently targeted therapy as the front-line therapy. Nevertheless, its presence did not affect the overall survival or relapse-free survival probably due to the emergence of efficient therapies. To conclude, rapid and accurate molecular establishment in adult clonal histiocytoses is crucial because BRAFV600E mutation correlates with multicentric disease with organ involvement and incomplete metabolic response.
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Affiliation(s)
- Jerome Razanamahery
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - Amelie Godot
- Department of Internal Medicine, Besancon University Hospital, Besancon, France
| | - Vanessa Leguy-Seguin
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - M. Samson
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - Sylvain Audia
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - Bernard Bonnotte
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
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71
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Wang L, Gong H, Jiang L, Gao S, Jiao Y. Rosai-Dorfman Disease of Nasal Soft Tissue: A Case Report. EAR, NOSE & THROAT JOURNAL 2023:1455613231195160. [PMID: 37740427 DOI: 10.1177/01455613231195160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is characterized by sinus histiocytosis with massive lymphadenopathy, and the tissue exhibits positive results for S100 and CD68. This lesion typically affects the lymph nodes and rarely involves the nasal soft tissues. This report aims to present a case of RDD involving the nasal soft tissues, presenting with nasal congestion and rhinorrhea as the primary complaints. The patient underwent surgery navigated by nasal endoscope did not report recurrence after operation.
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Affiliation(s)
- Liwen Wang
- Guangzhou Medical University, Guangzhou, China
- Guangzhou Twelfth People's Hospital, Guangzhou Otolaryngology-head and Neck Surgery Hospital, Guangzhou, China
| | - Huicheng Gong
- Guangzhou Twelfth People's Hospital, Guangzhou Otolaryngology-head and Neck Surgery Hospital, Guangzhou, China
| | - Linlan Jiang
- Guangzhou Medical University, Guangzhou, China
- Guangzhou Twelfth People's Hospital, Guangzhou Otolaryngology-head and Neck Surgery Hospital, Guangzhou, China
| | - Shuyi Gao
- Guangzhou Medical University, Guangzhou, China
| | - Yuenong Jiao
- Guangzhou Twelfth People's Hospital, Guangzhou Otolaryngology-head and Neck Surgery Hospital, Guangzhou, China
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72
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González Turienzo E, Domínguez Celis F, Martínez Ruiz de Apodaca P, Pons Rocher F. Coexistence of Rosai-Dorfman disease and Hodgkin's lymphoma in a patient with cervical lymphadenopathy. BMJ Case Rep 2023; 16:e254152. [PMID: 37723087 PMCID: PMC10510867 DOI: 10.1136/bcr-2022-254152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
A man in his 40s, with no tobacco or alcohol habit, was referred to the otorhinolaryngology department presenting with a 2-month history of enlarged left cervical lymphadenopathy with no other signs or symptoms. The ear, nose and throat examination showed no abnormalities apart from the described lymphadenopathy. An ultrasound scan suggested these nodes to be part of either an inflammatory or a malignant process. Subsequent positron emission tomography-CT proved those lymph nodes to be metabolically active, as well as others within the thorax. Cervicotomy was performed and the histopathological analysis showed dilated sinuses and histiocytes with emperipolesis. Suspecting Rosai-Dorfman disease (RDD), high-dose steroid therapy was started; but given no improvement was observed, a second cervicotomy was performed, with the histopathological diagnosis of the latter of Hodgkin's lymphoma. The present article aims to emphasise the need to exclude haematological disorders whenever RDD histology is observed, given their possible coexistence, and a worse outcome and clinical and histopathological semblance.
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Affiliation(s)
| | | | | | - Francisco Pons Rocher
- Otorrinolaringología, Hospital Universitario Doctor Peset, Valencia, Spain
- Cirurgia (Otorhinolaryngology), Universitat de Valencia Facultat de Medicina i Odontologia, Valencia, Spain
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73
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Hartmann T, Solomon N, Lerner G, Ehrlich L. Rosai-Dorfman Disease in a Pediatric Patient: Imaging Findings and Pathology with a brief review of the Literature. J Radiol Case Rep 2023; 17:1-14. [PMID: 38098961 PMCID: PMC10718311 DOI: 10.3941/jrcr.v17i8.4873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Rosai-Dorfman Disease, otherwise known as sinus histiocytosis with massive lymphadenopathy, is a rare form of non-Langerhans cell histiocytosis with an estimated incidence of 100 cases per year in the United States. Due to its variable presentation and nonspecific clinical findings, it is particularly difficult to diagnose in pediatric patients. We report a case of an 11-month-old male who presented with a 4-day history of a right groin mass. Ultrasound of the groin and pelvis demonstrated, and MRI of the abdomen and pelvis confirmed an inguinal mass with surrounding lymphadenopathy. Pathology confirmed Rosai-Dorfman Disease and the patient improved after starting oral steroid therapy. To the best of our knowledge, this is the first case of Rosai-Dorfman Disease involving the inguinal region in an infant under 1 year of age reported in the literature. In this case report, we discuss the imaging and histology findings as well as provide a brief literature review for this diagnosis.
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Affiliation(s)
- Thomas Hartmann
- Medical Student, University of Central Florida College of Medicine, Orlando, USA
| | - Nadia Solomon
- Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, USA
| | - Gabriel Lerner
- Department of Pathology and Laboratory Medicine, Yale New Haven Hospital, New Haven, USA
| | - Lauren Ehrlich
- Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, USA
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74
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Fay CJ, Moslehi D, Iriarte C, Dang TM, Virgen CA, Russell-Goldman E, LeBoeuf NR. Treatment-refractory cutaneous Rosai-Dorfman disease responsive to oral methotrexate and topical trametinib. JAAD Case Rep 2023; 39:74-77. [PMID: 37650013 PMCID: PMC10462782 DOI: 10.1016/j.jdcr.2023.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Affiliation(s)
- Christopher J. Fay
- Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Christopher Iriarte
- Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Timothy M. Dang
- Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Cesar A. Virgen
- Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Eleanor Russell-Goldman
- Harvard Medical School, Boston, Massachusetts
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Nicole R. LeBoeuf
- Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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75
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Lee NK, Lovell MA, Herrmann BW. Rosai-Dorfman-Destombes Disease in the Pediatric Head and Neck. Ann Otol Rhinol Laryngol 2023; 132:1121-1127. [PMID: 36330598 DOI: 10.1177/00034894221130822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND Rosai-Dorfman-Destombes disease (RDD), or sinus histiocytosis with massive lymphadenopathy, is a rare form of non-Langerhans cells histiocytosis. It has a wide-ranging variability in presentation since first described in 1969 but much of its characteristics in children remain unknown. METHODS A retrospective chart review of children diagnosed with RDD at a tertiary care children's hospital was conducted from 2000 to 2021. RESULTS Twelve RDD patients were identified, with an average age of 7 years (SD 4.3). Males comprised 58% of the cohort, and African American ethnicity was most common (42%). Nodal RDD was found in 7 patients (58%). Nine patients (75%) presented RDD within the head and neck, 6 of whom had nodal RDD. The most common presentation was cervical lymphadenopathy, which most often involved levels V (67%), II (56%), III (44%), and I (11%), in order of frequency. Recurrence and persistence of disease after initial treatment was common, with 5 (42%) being disease free at the time of the last follow up. Fifty-eight percent (7/12) developed recurrence or had persistent disease and 4 required adjuvant systemic treatment with corticosteroids and/or chemotherapy. One patient succumbed after developing treatment related acute myelodysplastic leukemia (t-AML) from chemotherapy used to treat recurrent RDD. CONCLUSION Pediatric RDD presents at a young age and most commonly involving cervical lymphadenopathy. Ongoing surveillance in the setting of persistence or recurrence without clearly defined prognostic risk factors is important.
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Affiliation(s)
- Nam K Lee
- Department of Otolaryngology-Head & Neck Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Mark A Lovell
- Department of Pathology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
- Children's Hospital Colorado, Aurora, CO, USA
| | - Brian W Herrmann
- Department of Otolaryngology-Head & Neck Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
- Children's Hospital Colorado, Aurora, CO, USA
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Zhang J, Cui R, Li J, Cao X, Luo Y. Characterizing Rosai-Dorfman disease with [ 18F]FDG PET/CT: a retrospective analysis of a single-center study. Eur Radiol 2023; 33:6492-6501. [PMID: 36971850 DOI: 10.1007/s00330-023-09561-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/23/2023] [Accepted: 02/26/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytic proliferative disorder. We performed a retrospective study to characterize the clinical and [18F]FDG PET/CT features of RDD. METHODS We retrospectively recruited 38 RDD patients with [18F]FDG PET/CT scan in our center. [18F]FDG PET/CT features were assessed, and clinical and follow-up data were recorded. RESULTS In the recruited patients, 20/38 (52.6%) patients had single-system disease, while others (18/38, 47.4%) had disease affecting multiple system. RDD most commonly involved the upper respiratory tract (47.4%), followed by cutaneous/subcutaneous lesion (39.5%), lymph node (36.8%), bone (31.6%), central nervous system (28.9%), and cardiovascular system (13.2%) in the recruited patients. In PET/CT, the RDD lesions were FDG-avid, and the SUVmax of the hottest lesion in an individual patient was positively correlated with C-reactive protein levels (r = 0.418, p = 0.014), and negatively correlated with hemoglobin levels (r = -0.359, p = 0.036). The overall response rate of the first-line treatment was 80.8% in newly diagnosed RDD patients, and for patients with relapsed/progressive RDD, the overall response rate was 72.7%. CONCLUSION [18F]FDG PET/CT could be a useful tool for evaluating RDD. KEY POINTS • About half of the patients with Rosai-Dorfman disease had single-system disease, while others had disease affecting multiple system. Rosai-Dorfman disease most commonly involved the upper respiratory tract, followed by cutaneous/subcutaneous lesion, lymph node, bone, central nervous system, and cardiovascular system. • In [18F]FDG PET/CT, Rosai-Dorfman disease was usually hypermetabolic, and the SUVmax of the hottest lesion in an individual patient was positively correlated with C-reactive protein levels. • Rosai-Dorfman disease usually has a high overall response rate after treatment.
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Affiliation(s)
- Jianan Zhang
- Department of Nuclear Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, 116023, People's Republic of China
| | - Ruixue Cui
- Department of Nuclear Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
- Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Jian Li
- Department of Hematology, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Xinxin Cao
- Department of Hematology, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.
| | - Yaping Luo
- Department of Nuclear Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.
- Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.
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77
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Rocamora-Blanch G, Climent F, Solanich X. [Histiocytosis]. Med Clin (Barc) 2023; 161:166-175. [PMID: 37263840 DOI: 10.1016/j.medcli.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 06/03/2023]
Abstract
Histiocytosis is a group of rare diseases characterized by inflammation and accumulation of cells derived from monocytes and macrophages in different tissues. The symptoms are highly variable, from mild forms with involvement of a single organ to severe multisystem forms that can be life compromising. The diagnosis of histiocytosis is based on the clinic, radiological findings and pathological anatomy. A biopsy of the affected tissue is recommended in all cases as it may have therapeutic implications. During the last decade, some mutations have been identified in the affected tissue that condition activation of the MAPK/ERK and PI3K/AKT pathway, in a variable proportion depending on the type of histiocytosis. In this review we mainly focus on Langerhans Cell Histiocytosis, Erdheim-Chester Disease and Rosai-Dorfman Disease.
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Affiliation(s)
- Gemma Rocamora-Blanch
- Servicio de Medicina Interna, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España.
| | - Fina Climent
- Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Servicio de Anatomía Patológica, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Xavier Solanich
- Servicio de Medicina Interna, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España
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78
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Nguyen T, Gutema M, Ye J, Backenstoss MS. Mammary Rosai-Dorfman disease: Rare benign mimic of breast malignant neoplasm. J Clin Imaging Sci 2023; 13:24. [PMID: 37680249 PMCID: PMC10481821 DOI: 10.25259/jcis_40_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/21/2023] [Indexed: 09/09/2023] Open
Abstract
Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is an uncommon benign disorder characterized by the accumulation of activated histiocytes in affected tissues. While RDD typically involves lymph nodes, it may manifest as extranodal involvement. Breast involvement is an exceedingly rare presentation of this condition with <100 reported cases worldwide. This report presents a case of RDD in a 58-year-old male patient who presented with a palpable breast mass. Mammography and ultrasound imaging studies raised concerns for malignancy, prompting a breast biopsy. Histopathological examination revealed S100-positive pale histiocytes exhibiting emperipolesis, consistent with RDD. The management of extranodal RDD is individualized, as no standardized guidelines are currently available. However, surgical excision is recommended for unicentric breast lesions, which was performed in our case, resulting in complete remission. The patient has remained disease-free under surveillance with computed tomography scans. Our case underscores the importance of considering RDD in the differential diagnoses of breast masses and highlights the utility of surgical excision as an effective treatment option, especially for unicentric breast lesions of RDD.
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Affiliation(s)
- Troy Nguyen
- College of Medicine, Lake Erie College of Osteopathic Medicine, Erie, United States
| | - Malem Gutema
- Department of Radiology, Rochester General Hospital, Rochester, New York, United States
| | - Jiquing Ye
- Department of Pathology, Rochester General Hospital, Rochester, New York, United States
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79
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Weeden EE, Mahil A, Huang J. Anesthetic Management for a Patient with Rosai-Dorfman Disease, Cowden Syndrome, and Lhermitte-Duclos Disease: An Extremely Rare Disease Combination. Cureus 2023; 15:e44318. [PMID: 37779808 PMCID: PMC10536452 DOI: 10.7759/cureus.44318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare condition that causes massive lymphadenopathy, most commonly in the cervical area. Cowden syndrome (CS) causes hamartomas in the skin and mucosa and predisposes individuals to various malignancies. Lhermitte-Duclos disease (LDD), or dysplastic cerebellar gangliocytoma, is often associated with CS. A 41-year-old female with all three conditions presented with abnormal uterine bleeding and endometrial intraepithelial neoplasia (EIN). Precautions should be considered when evaluating patients with RDD and CS preoperatively and during airway management owing to the potential for multisystem involvement, anatomical distortion, and difficult airways. The likelihood of having all three conditions is extremely rare.
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Affiliation(s)
- Emily E Weeden
- Anesthesiology Department, Moffitt Cancer Center, Tampa, USA
- Morsani College of Medicine, University of South Florida, Tampa, USA
| | - Amreesh Mahil
- Anesthesiology Department, Moffitt Cancer Center, Tampa, USA
| | - Jeffrey Huang
- Anesthesiology Department, Moffitt Cancer Center, Tampa, USA
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80
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van Laar Veth A, Brown J, Chen N, Bonar F. Isolated peri-renal extranodal Rosai-Dorfman disease rich in IgG4+ plasma cells. Pathology 2023; 55:723-726. [PMID: 36925344 DOI: 10.1016/j.pathol.2022.12.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/25/2022] [Accepted: 12/08/2022] [Indexed: 02/25/2023]
Affiliation(s)
- Alexander van Laar Veth
- Anatomical Pathology Department, SEALS Pathology, St George Hospital, Kogarah, NSW, Australia.
| | - Joanne Brown
- Anatomical Pathology Department, SEALS Pathology, St George Hospital, Kogarah, NSW, Australia
| | - Nicholas Chen
- Radiology Department, St George Hospital, Kogarah, NSW, Australia
| | - Fiona Bonar
- Anatomical Pathology Department, Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia
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81
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Zhang X, Zhou X, Liu H, Li D, Liu S, Lu Y. Successful anesthesia management with inhalation anesthesia in Rosai-Dorfman disease: a case report. J Int Med Res 2023; 51:3000605231195161. [PMID: 37647362 PMCID: PMC10469250 DOI: 10.1177/03000605231195161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare, benign, non-Langerhans cell histiocytic proliferative disease. RDD with central nervous system involvement is extremely rare. Surgical excision is generally regarded as the appropriate treatment of choice for this disease, especially when the lesion causes neurological compression. RDD can be accompanied by systemic symptoms, such as malaise, fever, weight change, leukocytosis, anemia, and hormonal disturbance, which may be challenging during general management. Little is known regarding peri-anesthesia management of this rare disease. We report a case of a patient in his 20s who had recurrent RDD and had general anesthesia with perioperative management. He was obese and hepatic insufficiency. This case report adds to the literature regarding the perioperative anesthetic management of RDD with central nervous system involvement.
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Affiliation(s)
- Xinlei Zhang
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiangjun Zhou
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hanjie Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dezhi Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Song Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yu Lu
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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82
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Laudin GE, Lakha AB, Dullabh N, Mohanlal R, Jassat R, Waja MF, Philip V. A meta-analysis of cases of Rosai Dorfman disease reported on the African continent and a description of two cases from a tertiary academic hospital in Johannesburg, South Africa. Pan Afr Med J 2023; 45:130. [PMID: 37790150 PMCID: PMC10543906 DOI: 10.11604/pamj.2023.45.130.40709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/28/2023] [Indexed: 10/05/2023] Open
Abstract
Rosai-Dorfman-Destombes disease (RDD) is a rare non-Langerhans cell histiocytosis characterized by the accumulation of activated histiocytes within affected tissues. The original haematopathological description of RDD has links to the late South African born haematopathologist, Ronald Dorfman, with a descriptive account of two cases of the disease treated at Chris Hani Baragwanath Academic Hospital are described herein. Alongside the two case descriptions is a meta-analysis of 149 published cases from the African continent. Sequential literature searches were performed on Google Scholar and PubMed with the search terms "sinus histiocytosis with massive lymphadenopathy", "Rosai-Dorfman disease", "Rosai-Dorfman Destombes" and "lymphadenopathy" together with the name of each individual country on the African continent, from Algeria to Zimbabwe. All possible cases of RDD reported in published literature from Africa were captured on a Microsoft Excel spreadsheet recording details, where available, of demographics, nodal (nodal groups) or extra-nodal disease as well as treatment. Of the 54 African countries on the continent, published data was available from half of these countries (n=27). Nigeria (35), Tunisia (25) and South Africa (23) contributed the majority of cases for data collection with a clear paucity of reportable information available from Central Africa. Of the 149 cases from the African continent, the majority were from patients aged ten years and younger with a decrease in reported cases in patients with increasing age. The mean age at diagnosis was 25.66 years [95% CI: 21.81-29.51] with a median age of diagnosis of 24.5 years. The youngest patient in the series was 3 months old and the oldest patient aged 72 (range 71.75 years, IQR 31). The cases reported were fairly split between males and females with a male-to-female ratio of 1.07: 1. HIV seropositivity was reported in seven patients (4.8%) and no HIV results were available in 104 patients (71.2%). Disease presentation was split between nodal disease in 43% of patients (n=64), Extra nodal (EN) disease in 32.9% (n=32), mixed (nodal/EN) disease in 11.4% (n=17) and unknown in 12.8% (n=19). Fever was present in 18.1% (n=27) of cases. Hepatic enlargement was noted in nine patients (6%) and splenic enlargement in four patients (2.7%). Commonly ascribed sites of EN disease, in descending order, were skin and soft tissue, ocular, ear/nose/throat (ENT), abdominal organ(s), bone, lung/pleura, brain parenchyma (including dura), endocrine glands, spine, breast, pericardium, pseudotumour formation (unspecified site), joint(s), peripheral nerves and genitourinary tract disease. The upfront administration of glucocorticosteroids was seen in the majority of cases. Rosai-Dorfman-Destombes, although a rare disorder, should be considered as a differential diagnosis in patients with massive bilateral cervical lymphadenopathy and is confirmed with accompanying pathological changes on microscopic and immunohistochemical examination of biopsy specimens. The role of infection, particularly HIV infection, is considered to be a possible contributor to the pathogenesis of RDD and HIV testing in patients from areas of high HIV endemicity with co-existing RDD should be undertaken. Consideration for mycobacterium tuberculosis infection in patients with generalized significant lymphadenopathy still remains an important differential for massive lymphadenopathy and requires confirmation by appropriate microbiological investigations. The treatment landscape in RDD is limited in many resource-poor settings, with the upfront use of glucocorticosteroids employed routinely in the majority of cases.
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Affiliation(s)
- Garrick Edouard Laudin
- Department of Medicine Clinical Haematology Unit, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Atul Baldev Lakha
- Department of Medicine Clinical Haematology Unit, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nishal Dullabh
- Department of Medicine, Charlotte Maxeke Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Reena Mohanlal
- Anatomical Pathology, School of Pathology, University of the Witwatersrand, National Health Laboratory Service, Johannesburg, South Africa
| | - Romana Jassat
- Department of Medicine Clinical Haematology Unit, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Muhammed Faadil Waja
- Department of Medicine Clinical Haematology Unit, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Vinitha Philip
- Department of Medicine Clinical Haematology Unit, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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83
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Rathinam A, Gupta S, Khanam R, Sahai T. A Case of Rosai-Dorfman Disease Presenting as an Isolated Pleural Plaque. Cureus 2023; 15:e41334. [PMID: 37546096 PMCID: PMC10398612 DOI: 10.7759/cureus.41334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare non-Langerhans histiocytic disorder primarily involving lymph nodes. Extranodal RDD has a heterogenous presentation, and isolated pulmonary involvement is rare. We report the only case of RDD presenting as an isolated pleural mass. Our patient was a 55-year-old female with multiple comorbidities who presented with chest pain. Imaging revealed an enlarging pleural-based lesion. She underwent resection of the pleural mass, showing an atypical histiocytic infiltrate in a prominent background of collagenous fibrosis. Immunohistochemistry shows CD1a-negative and S100-positive atypical histiocytic cells demonstrating emperipolesis, confirming the diagnosis of RDD. She is currently on six-month CT surveillance with no recurrence of the disease. This case highlights the unique pulmonary presentation of RDD. It also underscores that observations may be appropriate in isolated asymptomatic pleural involvement cases.
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Affiliation(s)
- Arun Rathinam
- Internal Medicine, Carle Foundation Hospital, Urbana, USA
| | - Sushan Gupta
- Internal Medicine, Carle Foundation Hospital, Urbana, USA
| | | | - Tanmay Sahai
- Hematology and Oncology, Carle Foundation Hospital, Urbana, USA
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84
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Lambdin J, Phillips JK, Kima ED, Paal E, Nava VE, Duncan J. Rosai-Dorfman Disease of the Rectum: Newly Identified Genetic Point Mutations and Robotic Resection. Am Surg 2023; 89:2897-2899. [PMID: 35187965 DOI: 10.1177/00031348211069800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Rosai-Dorfman disease (RDD) is a rare disease characterized by histiocytic proliferation which typically presents as massive, painless, cervical lymphadenopathy in children or young adults. GI involvement is exceedingly rare with only 20 documented cases to date. Of those 20 cases, only 3 cases have involved the rectum. Here, we present 2 cases of rectal RDD with attention paid to the diagnostic and technical challenges presented by this disease. When presenting as a perirectal mass, RDD can be mistaken for other lesions to include malignancy, leading to surgical removal. We present a video of a robotic low-anterior resection with intracorporeal anastomosis in order to remove a pelvic mass involving the rectum, initially considered to be a stromal tumor. In addition, we describe a copy number variation in AKT and 3 point mutations detected by next generation sequencing, which had not been previously reported in association with this disease.
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Affiliation(s)
- Jacob Lambdin
- Department of Surgery, The George Washington University Hospital, Washington, DC, USA
| | - Joshua K Phillips
- Department of Surgery, The George Washington University Hospital, Washington, DC, USA
| | - Elias D Kima
- Pathology and Laboratory Medicine Service, Department of Veterans Affairs Medical Center, Washington, DC, USA
| | - Edina Paal
- Department of Surgery, The George Washington University Hospital, Washington, DC, USA
- Pathology and Laboratory Medicine Service, Department of Veterans Affairs Medical Center, Washington, DC, USA
| | - Victor E Nava
- Department of Surgery, The George Washington University Hospital, Washington, DC, USA
- Pathology and Laboratory Medicine Service, Department of Veterans Affairs Medical Center, Washington, DC, USA
| | - James Duncan
- Pathology and Laboratory Medicine Service, Department of Veterans Affairs Medical Center, Washington, DC, USA
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85
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Cao G, Xie S, Li M, Yang X, Zhu J, Zhang L. Imaging diagnostic features of intracranial primary extranodal Rosai-Dorfman disease: Two case reports and literature review. Radiol Case Rep 2023; 18:2165-2171. [PMID: 37089978 PMCID: PMC10120362 DOI: 10.1016/j.radcr.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/10/2023] [Accepted: 03/02/2023] [Indexed: 04/25/2023] Open
Abstract
In this report, we describe 2 cases of rare intracranial extranodal Rosai-Dorfman disease. The occurrence of this type of non-Langerhans cell histiocytosis in the central nervous system is infrequent, with less than 5% of cases. The first patient was a 35-year-old male who presented with recurring headaches, and the second patient was a 50-year-old male who reported sudden onset of dizziness and vomiting. Computed tomography scans were performed in both cases, but magnetic resonance imaging played a crucial role in the characterization of the lesions and their locations in the thalamus, third ventricle, lateral ventricles, and cerebellopontine angle area. The final diagnosis was confirmed through pathological examination and immunohistochemistry following brain tumor resection. These cases underscore the significance of magnetic resonance imaging in the early diagnosis of intracranial extranodal Rosai-Dorfman disease.
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86
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Soto-Davila C, Klapper R, Afude J, Sangster G, Previgliano C. Synchronous Mediastinal and Central Nervous System Involvement in Rosai-Dorfman Disease: A Case Report. Cureus 2023; 15:e39984. [PMID: 37416014 PMCID: PMC10321357 DOI: 10.7759/cureus.39984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 07/08/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare disorder characterized by the proliferation and accumulation of histiocytes, primarily within lymph node sinuses. Uncommonly, other extranodal sites, such as the central nervous system, can also be affected. Here, we document the case of a 61-year-old woman presenting with dizziness, confusion, and headaches. Magnetic resonance imaging (MRI) showed an extra-axial avidly enhancing mass in the left parietal region presumed to be a meningioma based solely on its imaging appearance. The patient underwent surgical resection, and histopathological examination showed enlarged histiocytes positive for S100, CD68, and CD163 and negative for CD1a, consistent with RDD. She was followed up with a positron emission tomography/computed tomography (PET/CT) to evaluate other disease activity sites. A single mediastinal node was identified adjacent to the atriocaval junction intensely fluorodeoxyglucose avid. The patient underwent robotic node excision, with pathology analysis compatible with RDD. We emphasize the need to increase recognition of RDD on differential brain lesions, especially meningiomas, and suggest PET/CT as a valid tool to search for other disease activity lesions.
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Affiliation(s)
| | - Rachel Klapper
- Radiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Jacob Afude
- Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Guillermo Sangster
- Radiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Carlos Previgliano
- Radiology, Louisiana State University Health Sciences Center, Shreveport, USA
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87
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Yan K, Xu X. Sporadic Red Papules on the Face: A Quiz. Acta Derm Venereol 2023; 103:adv11662. [PMID: 37219502 DOI: 10.2340/actadv.v103.11662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/21/2023] [Indexed: 05/24/2023] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Kexin Yan
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Xiulian Xu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
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88
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Geerlinks AV, Abla O. Treatment of Langerhans Cell Histiocytosis and Histiocytic Disorders: A Focus on MAPK Pathway Inhibitors. Paediatr Drugs 2023:10.1007/s40272-023-00569-8. [PMID: 37204611 DOI: 10.1007/s40272-023-00569-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 05/20/2023]
Abstract
Histiocytic disorders are rare diseases defined by the clonal accumulation of a macrophage or dendritic cell origin. These disorders include Langerhans cell histiocytosis, Erdheim-Chester disease, juvenile xanthogranuloma, malignant histiocytoses, and Rosai-Dorfman-Destombes disease. These histiocytic disorders are a diverse group of disorders with different presentations, management, and prognosis. This review focuses on these histiocytic disorders and the role of pathological ERK signaling due to somatic mutations in the mitogen--activated protein kinase (MAPK) pathway. Over the last decade, there has been growing awareness of the MAPK pathway being a key driver in many histiocytic disorders, which has led to successful treatment with targeted therapies, in particular, BRAF inhibitors and MEK inhibitors.
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Affiliation(s)
- Ashley V Geerlinks
- Pediatric Hematology/Oncology, Western University and Children's Hospital London Health Sciences Centre, London, ON, Canada.
| | - Oussama Abla
- Division of Haematology/Oncology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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89
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Butt AH, Peterzan M, Shah C, Wright M, Rinaldi CA, Gill J, Kapetanakis S, Behar JM. Interatrial Septal Mass Secondary to Rosai-Dorfman Disease: A Rare Cause of Complete Heart Block. JACC Case Rep 2023; 14:101824. [PMID: 37152702 PMCID: PMC10157082 DOI: 10.1016/j.jaccas.2023.101824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 05/09/2023]
Abstract
Varying degrees of atrioventricular block can be associated with old age or a manifestation of an ischemic, metabolic, or infective pathology. In patients with no clear explanation, it is important to investigate secondary causes. Our case describes the first case of an adult with Rosai-Dorfman histiocytosis presenting with complete heart block. (Level of Difficulty: Advanced.).
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Affiliation(s)
- Abdul Hadi Butt
- Address for correspondence: Dr Abdul Hadi Butt, 9 The Close, Dartford, DA2 7ES, United Kingdom.
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90
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Lu X, Wang R, Zhu Z. The value of 18F-FDG PET/CT in the systemic evaluation of patients with Rosai-Dorfman disease: a retrospective study and literature review. Orphanet J Rare Dis 2023; 18:116. [PMID: 37179326 PMCID: PMC10182668 DOI: 10.1186/s13023-023-02711-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Rosai-Dorfman disease (RDD) is a rare form of non-Langerhans cell histiocytic disease. The aim of this study was to review the characteristics of RDD using 18F-FDG PET/CT and determine its efficacy in the disease management. RESULTS A total of 28 RDD patients underwent 33 18F-FDG PET/CT scans for systematic assessment and follow-up. The common involved sites included the lymph nodes (17, 60.7%), upper respiratory tract (11, 39.3%), and skin (9, 32.1%). Five patients had more lesions detected in PET/CT images than in CT and/or MRI, including inapparent nodules (n = 5) and bone destruction (n = 3). After thorough treatment evaluation using PET/CT, the treatment strategies of 14 patients (14/16, 87.5%) were changed. Five patients underwent PET/CT twice during follow-up and the SUVs were significantly decreased (15.3 ± 3.4 vs. 4.4 ± 1.0, p = 0.02), which demonstrated disease improvement. CONCLUSIONS 18F-FDG PET/CT contributed to displaying the holistic characteristics of RDD, in particular during initial assessment, treatment strategy adjustment, or efficacy evaluation, and could compensate for some disadvantages of CT and MRI images.
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Affiliation(s)
- Xinyu Lu
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Beijing, 100730, China
| | - Rongxi Wang
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Beijing, 100730, China
| | - Zhaohui Zhu
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
- State Key Laboratory of Complex Severe and Rare Diseases, Beijing, 100730, China.
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91
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Ravindran A, Rech KL. How I Diagnose Rosai-Dorfman Disease. Am J Clin Pathol 2023:7160235. [PMID: 37167084 DOI: 10.1093/ajcp/aqad047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/05/2023] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVES Rosai-Dorfman disease (RDD) is one of 3 major types of histiocytosis, along with Erdheim-Chester disease and Langerhans cell histiocytosis. While historically, RDD was considered a benign self-limited condition, current data show MAPK/ERK pathway mutations in 30% to 50% of cases, indicative of a clonal process. Rosai-Dorfman disease was incorporated as a histiocytic neoplasm in the fifth edition of the World Health Organization classification of hematopoietic tumors and the International Consensus Classification. METHODS We discuss the diagnosis of RDD using 2 illustrative cases, interpretative challenges, and a diagnostic algorithm. RESULTS Rosai-Dorfman disease involves nodal and extranodal sites, including skin, sinuses, salivary gland, orbit, central nervous system, kidney, and bone. In a subset, RDD can coexist with other neoplasms (lymphomas, other histiocytosis) or autoimmune disease. Morphologically, RDD histiocytes are characterized by enlarged round to oval nuclei, distinct nucleoli, and voluminous cytoplasm with engulfment of inflammatory cells (emperipolesis). By immunohistochemistry, they express CD68, CD163 (majority), S100, OCT2, and cyclin D1. Appropriate use of ancillary studies is important to support the diagnosis of RDD while excluding other histiocytic neoplasms and reactive histiocytic proliferations. CONCLUSIONS Management of RDD is dependent on the extent of organ involvement and clinical symptoms. In patients who require therapy, next-generation sequencing is recommended to identify MAPK/ERK pathway mutations for targeted therapy.
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Affiliation(s)
- Aishwarya Ravindran
- Department of Pathology, Division of Laboratory Medicine-Hematopathology, University of Alabama at Birmingham, Birmingham, AL, US
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Karen L Rech
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
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92
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Alexander B, Alshaikhli A, Bartl M, Ng-Wong YK, Dulgheru EC. A Rare Cause of Lymphadenopathy in a Young Hispanic Female: Unmasking Recurrent Nodal Rosai-Dorfman Disease. Cureus 2023; 15:e39131. [PMID: 37378192 PMCID: PMC10292128 DOI: 10.7759/cureus.39131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/29/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare histiocytic disorder that can present with painless bilateral symmetrical cervical lymphadenopathy, mimicking lymphomas. RDD is characterized by excessive tissue infiltration by dendritic cells, macrophages, or monocyte-derived cells, with a histopathologic diagnosis based on the presence of CD68+, CD163+, and S100+ histiocytes, which differentiate it from other histiocytic neoplasms. In this case report, we present a young Hispanic female with recurrent subcutaneous growths and lymphadenopathy, initially thought to be lymphoma, who was diagnosed with RDD after a significant diagnostic workup. Treatment initially consisted of surgical excision; however, due to recurrence, the patient was successfully treated with corticosteroids and a steroid-sparing agent, 6-mercaptopurine, with significant improvement in symptoms. RDD should be considered a differential diagnosis for patients with cervical lymphadenopathy, and an interdisciplinary approach is essential to managing this rare disorder effectively. The report highlights the need for an interdisciplinary approach to managing this rare disorder effectively and underscores the importance of multimodal treatment in disease suppression. As a rare disease with slow advancement of defined guidelines for diagnostic and treatment strategies, this case report adds to the existing literature on RDD.
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Affiliation(s)
- Blesset Alexander
- Internal Medicine, University of Texas Rio Grande Valley, Edinburg, USA
- Internal Medicine, DHR Health, Edinburg, USA
| | | | - Mery Bartl
- Internal Medicine, University of Texas Rio Grande Valley, Edinburg, USA
| | - Yilen K Ng-Wong
- Internal Medicine, University of Texas Rio Grande Valley, Edinburg, USA
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93
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Tan GSL, Chan CW. Rosai-Dorfman disease of the breast: the breast cancer mimic. BMJ Case Rep 2023; 16:e255378. [PMID: 37045551 PMCID: PMC10105984 DOI: 10.1136/bcr-2023-255378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Affiliation(s)
- Grace Siew Lim Tan
- Division of Oncologic Imaging, National Cancer Centre Singapore, Singapore
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94
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Gallo JR, Paira S, Hernández-Molina G, Delgado-de la Mora J, Montante-Montes de Oca D, Martín-Nares E. Immunoglobulin G4-Associated Rosai-Dorfman Disease: Report of 3 Cases. Eur J Rheumatol 2023; 10:57-61. [PMID: 37249306 PMCID: PMC10543072 DOI: 10.5152/eurjrheum.2023.22064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 03/02/2023] [Indexed: 05/31/2023] Open
Abstract
Rosai-Dorfman disease is characterized by dilated lymph node sinuses filled with lymphocytes, plasma cells, and histiocytes. Many of these histiocytes classically exhibit emperipolesis of lymphocytes and plasma cells. Abundant immunoglobulin G4+ plasma cells occur in some cases, and a potential relationship with immunoglobulin G4-related disease has been suggested. Here, we report 3 cases of immunoglobulin G4-associated Rosai-Dorfman disease. Immunoglobulin G4-related disease was suspected based on immunoglobulin G4+ plasma cell infiltration, but the final diagnosis was immunoglobulin G4-associated Rosai-Dorfman disease. At present, the evidence does not support a link between immunoglobulin G4-associated Rosai-Dorfman disease and immunoglobulin G4-related disease, and one condition should not be considered part of the spectrum of the other. We believe it is of paramount importance to increase the awareness of immunoglobulin G4-associated Rosai-Dorfman disease for pathologists who interpret the biopsies and clinicians who integrate the diagnosis and treat such patients to not overdiagnose immunoglobulin G4-related disease.
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Affiliation(s)
- Jesica Romina Gallo
- Section of Rheumatology, Hospital Central de Reconquista, Santa Fe, Argentina
| | - Sergio Paira
- Section of Rheumatology, Hospital J. M. Cullen, Santa Fe, Argentina
| | - Gabriela Hernández-Molina
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City, Mexico
| | - Jesús Delgado-de la Mora
- Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico City, Mexico
| | - Daniel Montante-Montes de Oca
- Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico City, Mexico
| | - Eduardo Martín-Nares
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City, Mexico
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95
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Dronamraju V, McSurdy K, Graham R, Rali P, Kumaran M, Proca D, Lashari B, Toyoda Y, Gupta R. A rare case of Rosai-Dorfman disease presenting as a pulmonary artery mass in a 33-year-old female with hypoxia. Pulm Circ 2023; 13:e12214. [PMID: 37007934 PMCID: PMC10064855 DOI: 10.1002/pul2.12214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 04/04/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare form of non-Langerhans histiocytosis. It is often idiopathic in etiology, but has been associated with viral, autoimmune, and malignant disease. Adequate diagnosis of RDD requires a combination of clinical symptoms, radiography, and histology. Most commonly, patients with RDD present with cervical lymphadenopathy. We describe a case of a young female who was initially thought to have a pulmonary embolism at the time of a COVID-19 infection but was noted to have a rare occurrence of RDD presenting as a pulmonary artery mass upon further evaluation of radiology and histology. Though RDD is frequently benign, extranodal involvement can progress to end organ damage and must be recognized appropriately.
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Affiliation(s)
- Veena Dronamraju
- Department of Thoracic Medicine and SurgeryTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Kaitlyn McSurdy
- Department of MedicineTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Ryan Graham
- Department of RadiologyTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Parth Rali
- Department of Thoracic Medicine and SurgeryTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Maruti Kumaran
- Department of RadiologyTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Daniela Proca
- Department of Pathology and Laboratory MedicineTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Bilal Lashari
- Department of Thoracic Medicine and SurgeryTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Yoshiya Toyoda
- Department of Cardiovascular SurgeryTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Rohit Gupta
- Department of Thoracic Medicine and SurgeryTemple University HospitalPhiladelphiaPennsylvaniaUSA
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96
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Elira Dokékias A, Galiba Atipo Tsiba FO, Bissiko F, Martin A. [Cervical tumefaction in a child at Brazzaville University Hospital, Republic of the Congo]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2023; 3:mtsi.v3i1.2023.340. [PMID: 37389375 PMCID: PMC10300660 DOI: 10.48327/mtsi.v3i1.2023.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/28/2023] [Indexed: 07/01/2023]
Abstract
A 8-year-old schoolgirl from West Africa with no previous pathological history was admitted to the haematology department of the Brazzaville University Hospital for the management of cervical adenopathy. The diagnosis of sinus histiocytosis or Destombes-Rosaï-Dorfman disease was retained and the patient was treated with PO corticosteroids (methylprednisolone 32 mg/d then 16 mg/d). Given the rarity and uncertain aetiopathogeny of this syndrome, treatment is poorly codified. It includes corticosteroid therapy, immunomodulators and sometimes chemotherapy, radiotherapy or surgery, indicated in case of clinical manifestations of local organ compression. The disease may regress spontaneously. Its benignity does not justify systematic treatment in the absence of complications.
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Affiliation(s)
- Alexis Elira Dokékias
- Service d'hématologie du CHU de Brazzaville et Centre national de référence de la drépanocytose (CNRD) « Antoinette Sassou N'Guesso », Brazzaville, République du Congo
| | - Firmine Olivia Galiba Atipo Tsiba
- Service d'hématologie du CHU de Brazzaville et Centre national de référence de la drépanocytose (CNRD) « Antoinette Sassou N'Guesso », Brazzaville, République du Congo
| | | | - Antoine Martin
- Département de cytologie et anatomie pathologiques, Hôpital Avicenne, Bobigny, France
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97
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Xu H, Zhang H, Li W, Zhang C, Wang H, Wang D. Nasal Presentations of Rosai-Dorfman Disease: Clinical Manifestation and Treatment Outcomes. EAR, NOSE & THROAT JOURNAL 2023:1455613231162226. [PMID: 36884341 DOI: 10.1177/01455613231162226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
PURPOSE There has been a lack of evidence-based management strategies on the nasal presentations of Rosai-Dorfman disease (RDD). We aim to investigate the clinical manifestation, treatment, and outcomes in patients with nasal RDD. METHODS We retrospectively reviewed available medical records of patients diagnosed with nasal RDD from 2014 to 2021 at our department. RESULTS A total of 26 patients were included with a marked female preponderance (2.25:1). The most common symptom and affected sites were nasal congestion (31%) and nasal cavity (73%), respectively. The average times of biopsies was 1.5 times (range: 1-3). The histiocytes were positive about S100 and CD68 and negative for CD1a with common emperipolesis. The mean duration of follow-up was 34 months (range, 3-87). One patient with concomitant nasal small B-cell lymphoma achieved complete remission after chemoradiotherapy. Recommended treatments were endoscopic resection (92%) and oral corticosteroids (21%). Surgery was performed to remove the resectable lesion as completely as possible. Corticosteroids induced almost 100% overall remission. Of the relapses, two patients achieved an overall response and one remained in progressive stage after subsequent excision. Two patients only received dissection biopsy that responded to oral corticosteroid administration and combined therapies of lenalidomide and dexamethasone, respectively. CONCLUSIONS Diffuse lesions in nasal cavity and sinuses, and even widely affected nasal skull base, laryngopharynx, orbit, and cavernous sinus, should be considered the possibility of Rosai-Dorfman disease. Characteristic immunohistochemical staining is helpful for the diagnosis. Endoscopic surgical therapy remains the mainstream treatment for patients enduring an unbearable course. Oral corticosteroid administration serves as an adjuvant therapy for first-line treatments.
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Affiliation(s)
- Haoyuan Xu
- ENT Institute and Department of Otorhinolaryngology, Affiliated ENT Hospital, Fudan University, Shanghai, China
| | - Huankang Zhang
- ENT Institute and Department of Otorhinolaryngology, Affiliated ENT Hospital, Fudan University, Shanghai, China
| | - Wanpeng Li
- ENT Institute and Department of Otorhinolaryngology, Affiliated ENT Hospital, Fudan University, Shanghai, China
| | - Chen Zhang
- ENT Institute and Department of Otorhinolaryngology, Affiliated ENT Hospital, Fudan University, Shanghai, China
| | - Huan Wang
- ENT Institute and Department of Otorhinolaryngology, Affiliated ENT Hospital, Fudan University, Shanghai, China
| | - Dehui Wang
- ENT Institute and Department of Otorhinolaryngology, Affiliated ENT Hospital, Fudan University, Shanghai, China
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98
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Moore CE, Flint JH, Taniguchi KM, Gable PS. Rosai-Dorfman: Rare Manifestations of a Rare Disease. Cureus 2023; 15:e36673. [PMID: 37102025 PMCID: PMC10124758 DOI: 10.7759/cureus.36673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2023] [Indexed: 04/28/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is an exceedingly rare non-Langerhans cell histiocytosis of uncertain etiology that most commonly presents in children as self-limited, painless, massive cervical lymphadenopathy. However, extranodal disease occurs in 43% of cases and has a wide range of phenotypic presentations. The pathogenesis has not been clearly understood in the literature and coupled with a wide range of clinical manifestations, early diagnosis and initiation of an appropriate treatment modality have been challenging. Herein, we describe a cohort of five cases that occurred at the same institution within a 12-month period. These cases highlight unique and atypical presentations of an already rare disease, outline the varying and tailored diagnostic and therapeutic approaches, and propose a novel environmental predisposing factor given the exceptionally high incidence at our institution over a short period of time. We emphasize the need for further investigation of predisposing factors and to discern targeted therapies that may offer benefits.
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Affiliation(s)
- Caroline E Moore
- Internal Medicine, Navy Medicine Readiness and Training Command San Diego, San Diego, USA
| | - James H Flint
- Orthopedic Surgery/Orthopedic Oncology, Navy Medicine Readiness and Training Command San Diego, San Diego, USA
| | - Kevin M Taniguchi
- General Surgery, Navy Medicine Readiness and Training Command San Diego, San Diego, USA
| | - Preston S Gable
- Hematology and Medical Oncology, Navy Medicine Readiness and Training Command San Diego, San Diego, USA
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99
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Yagi H, Amiya E, Uehara M, Minatsuki S, Hatano M, Takeda N, Akazawa H, Komuro I. Coronary periarteritis and pericardial thickening could be predictors for coronary artery events complicated by immunoglobulin G4-related disease. CJC Open 2023. [DOI: 10.1016/j.cjco.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
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100
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Lu A, Xie X, Han J, Yu J, Qin X, Xu P. Asymptomatic Rosai-Dorfman-Destombes disease presenting as isolated bilateral perinephric infiltration: a case report and review of the literature. Transl Androl Urol 2023; 12:347-352. [PMID: 36915883 PMCID: PMC10005998 DOI: 10.21037/tau-22-742] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/20/2023] [Indexed: 02/12/2023] Open
Abstract
Background Rosai-Dorfman-Destombes disease (RDD) is a rare histioproliferative disease with unknown etiology. It commonly occurs in lymph nodes and can affect extra-nodal tissues and organs. Renal RDD is extremely rare, only a few cases have been reported, and its clinical symptoms and imaging findings are non-specific. To date, no literature has summarized its imaging manifestations in a large number of cases. Due to the involvement of different tissues and organs, there is no standard treatment for RDD. It has been reported that RDD patients with kidney involvement have a poor prognosis. Thus, understanding of renal RDD need to be extended. Case Description We present a rare case of renal RDD in an asymptomatic 67-year-old male. The results of an ultrasound examination indicated that both kidneys were surrounded by hypoechoic soft tissue lesions, and there was a huge mass in the left kidney, which had a clear boundary with the renal capsule. The results of contrast-enhanced ultrasound (CEUS) showed hypo-enhancement in the bilateral perinephric lesions and mass. However, the computed tomography urography (CTU) findings revealed no obvious enhancement. The patient then underwent a series of laboratory tests, but no relevant information was found. To make a clear diagnosis, the urologist then removed the left perirenal mass and some perirenal tissues, and the patient was finally pathologically diagnosed with extra-nodal RDD. The patient remains asymptomatic, and no treatment has been administered to date. Conclusions This case may be the first reported case in which CEUS was performed and the second reported case of asymptomatic renal RDD. Based on the previous literature reports, we found that some specific characteristics of renal RDD include bilateral perirenal lesions with a "hairy kidney" appearance. CEUS and/or CTU can be used to help differentiate a solitary mass of RDD from common tumors, to avoid misdiagnosis leading to unnecessary nephrectomy.
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Affiliation(s)
- Aimei Lu
- Department of Ultrasound, Ningbo Yinzhou Second Hospital, Ningbo, China
| | - Xiaohong Xie
- Department of Ultrasound, Ningbo Yinzhou Second Hospital, Ningbo, China
| | - Jinyan Han
- Department of Ultrasound, Ningbo Yinzhou Second Hospital, Ningbo, China
| | - Jingjing Yu
- Department of Pathology, Ningbo Yinzhou Second Hospital, Ningbo, China
| | - Xiangcheng Qin
- Department of Urology, Ningbo Yinzhou Second Hospital, Ningbo, China
| | - Ping Xu
- Department of Ultrasound, Ningbo Yinzhou Second Hospital, Ningbo, China
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