101
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Wang Q, Ren H, Zheng L, Wang J, Zhong D. Recurrent central nervous system Rosai-Dorfman disease with KRAS mutation: a case report. Diagn Pathol 2023; 18:21. [PMID: 36782249 PMCID: PMC9926849 DOI: 10.1186/s13000-022-01276-7] [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: 01/07/2022] [Accepted: 12/19/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Rosai-Dorfman disease (RDD) is a rare, non-Langerhans cell histiocytosis of unknown etiology. we report a very rare case of recurrent central nervous system RDD with KRAS gene mutation and review the literature to improve our understanding of this disease. CASE PRESENTATION A 19-year-old male patient was admitted to our hospital for headache. Cranial magnetic resonance imaging revealed a mass of abnormal signal shadows in the prepontine cistern. The mass was surgically removed and the patient was consequently diagnosed with intracranial Rosai-Dorfman disease. Seven months later, pathological examination confirmed that the RDD had recurred. Next-generation sequencing found KRAS mutation in exon 4 (C.351A > C. P. K117n). CONCLUSION RDD of the CNS has no distinct clinical manifestations and imaging characteristics, and the final diagnosis should be based on the results of the pathological examination. Although RDD is not currently classified as a neoplastic disorder, some evidence of clonality has changed our understanding of it. Follow up examinations over a long period are necessary to determine the efficacy of treatment.
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Affiliation(s)
- Qingyang Wang
- grid.506261.60000 0001 0706 7839Graduate School of Peking Union Medical College, Beijing, 100006 China ,grid.415954.80000 0004 1771 3349Department of Pathology, China-Japan Friendship Hospital, Beijing, 100029 China
| | - Hongxiang Ren
- grid.415954.80000 0004 1771 3349Department of Neurosurgery, China-Japan Friendship Hospital, Beijing, 100029 China
| | - Liyuan Zheng
- grid.415954.80000 0004 1771 3349Department of Pathology, China-Japan Friendship Hospital, Beijing, 100029 China
| | - Juan Wang
- grid.506261.60000 0001 0706 7839Graduate School of Peking Union Medical College, Beijing, 100006 China ,grid.415954.80000 0004 1771 3349Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029 China
| | - Dingrong Zhong
- Graduate School of Peking Union Medical College, Beijing, 100006, China. .,Department of Pathology, China-Japan Friendship Hospital, Beijing, 100029, China.
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102
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Yazbeck M, Comair Y, Berjaoui C, Dabboucy B. Craniocervical Rosai-Dorfman Disease presentation: Case report and review of literature. NEUROCIRUGIA (ENGLISH EDITION) 2023:S2529-8496(22)00093-4. [PMID: 36774252 DOI: 10.1016/j.neucie.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/21/2022] [Indexed: 02/11/2023]
Abstract
Rosai Dorfman Disease (RDD) is a benign histiocytic lymphoproliferative disease that has variable presentations. The concurrent presentation of RDD in the spinal cord and brain parenchyma is an extremely rare entity. Here, we report another case of a 24-year-old gentleman who presented with a tuberculum sellae and bilateral cavernous extra-axial tumors extending to the subtemporal lobe and was found to have craniocervical lesions. Axillary lymph node biopsy was done showing markedly dilated sinuses filled with large histiocytes and emperipolesis of numerous lymphocytes and plasma cells confirming the diagnosis of RDD. Because the definitive diagnosis of RDD is always pathological, the clinical presentation plays a major role in widening the margin of differential diagnosis. Finally, surgical intervention is the first option to treat RDD with relatively satisfactory follow-up outcomes, and other adjuvant therapies optimize the prognosis.
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Affiliation(s)
- Mohamad Yazbeck
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Youssef Comair
- Youssef Comair: Department of Neurosurgery, Clemenceau Medical Center, Beirut, Lebanon
| | - Christin Berjaoui
- Christin Berjaoui: Department of Medicine and Surgery, Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | - Baraa Dabboucy
- Baraa Dabboucy: Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon.
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103
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Intracranial Rosai-Dorfman disease with hypopituitarism and eventual death: A rare case report. Asian J Surg 2023; 46:1038-1039. [PMID: 35961894 DOI: 10.1016/j.asjsur.2022.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 02/08/2023] Open
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104
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Kokje V, De Vito C, Varela FC, Monnier Y, Dulguerov N, Becker M, Mermod M. Rosai-Dorfman disease presenting as stridor and hoarseness in a young female patient. Radiol Case Rep 2023; 18:591-595. [PMCID: PMC9703459 DOI: 10.1016/j.radcr.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Vivianne Kokje
- Department of Otorhinolaryngology—Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Claudio De Vito
- Division of Clinical Pathology, Diagnostic Department, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Flavia Costa Varela
- Department of Otorhinolaryngology—Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
- Division of Clinical Pathology, Diagnostic Department, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
- Service of Radiology, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Yan Monnier
- Department of Otorhinolaryngology—Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Nicolas Dulguerov
- Department of Otorhinolaryngology—Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Minerva Becker
- Service of Radiology, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Maxime Mermod
- Department of Otorhinolaryngology—Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
- Corresponding author.
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105
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Magableh HM, Jaber HD, Magableh AM, Alrabiah MA, Dahhan AF, Azzam AZ, Amin T. Rosai-Dorfman Disease: Case Series and Literature Review. Cureus 2023; 15:e35193. [PMID: 36960255 PMCID: PMC10030647 DOI: 10.7759/cureus.35193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 02/22/2023] Open
Abstract
Rosai-Dorfman Disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is an uncommon histiocytic condition characterized by massive histopathological aggregation of CD1-a negative, CD68-positive, and S100-positive histiocytes. It was initially described by Destombes in 1965 under the term "adenitis with lipid excess." However, it is named after Rosai and Dorfman who reported further histopathological features of the disease in 1969. The diagnosis of this non-Langerhans cell histiocytosis can be challenging and requires high clinical suspicion. The diagnostic process usually involves imaging, tissue biopsies, and genetic testing as needed. In this case series, we are presenting three cases of rare disease. Case 2 had both nodal and extranodal forms, which makes this case rarer than cases 1 and 3, which present with extranodal lesions.
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Affiliation(s)
| | - Hamzh D Jaber
- College of Medicine, Alfaisal University, Riyadh, SAU
| | | | | | | | - Ayman Z Azzam
- Department of Surgical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
- Department of General Surgery, Faculty of Medicine, Alexandria University, Alexandria, EGY
| | - Tarek Amin
- Department of Surgical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
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106
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Snoussi M, Derbel A, Hentati Y, Mnif Z, Marzouk S, Bahloul Z. Subglottic Masses Revealing Rosai-Dorfman Disease. Eur J Case Rep Intern Med 2023; 10:003389. [PMID: 36819645 PMCID: PMC9930883 DOI: 10.12890/2023_003389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/27/2022] [Indexed: 02/04/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is an uncommon lymphoproliferative disorder; RDD with oropharyngeal involvement is extremely rare, especially in adults. A 65-year-old woman with a complaint of progressive dyspnoea since 2016 presented with laryngeal involvement of RDD. A laryngoscopy examination revealed two solid, polypoid masses in the subglottic region, and a laryngeal biopsy concluded chronic inflammation without signs of malignancy. A second biopsy of axillary lymph nodes was performed, supporting the diagnosis of histiocytosis. The patient was treated with corticosteroids and then lost to follow-up. In 2019, she suffered from dyspnoea and a hoarse voice. Laryngoscopy examination showed a polypoid lesion causing airway obstruction at 70% and thickening of the lateral wall of the cavum. Physical examination found left axillary and submandibular adenopathy, and computed tomography revealed thickening of the supraglottic larynx narrowing the laryngeal pathway. Lymphadenectomy with immunohistochemical analysis revealed typical protein positive S-100 histiocytes and emperipolesis. The patient was treated with high doses of corticosteroids for six weeks then these were progressively decreased. The outcome was favourable; the laryngeal lesion disappeared after two weeks of treatment. LEARNING POINTS Rosai-Dorfman disease is a rare cause of lymphadenopathy in adults. Extranodal presentation of the disease is possible mainly in the head and the neck region.The diagnosis is based on histological examination with the presence of histiocytes, which are S-100 positive, CD68 positive, and CD1a negative immunohistochemistry.The outcome is usually good in asymptomatic forms of the disease with no critical organ involved. The surgical resection is appropriate to the localised symptomatic form of the disease while corticosteroids are indicated in disseminated RDD as a first-line therapy.Inspired by our case, rare localisation of Rosai-Dorfman disease (RDD), led to clinical and therapeutic issues. That is why a review of the literature must be undertaken, to share experiences.
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Affiliation(s)
- Mouna Snoussi
- Department of Internal Medicine, Hedi Chaker Hospital, Sfax, Tunisia
| | - Abir Derbel
- Department of Internal Medicine, Hedi Chaker Hospital, Sfax, Tunisia
| | - Yosr Hentati
- Department of Medical Imaging, Hedi Chaker Hospital, Sfax, Tunisia
| | - Zeineb Mnif
- Department of Medical Imaging, Hedi Chaker Hospital, Sfax, Tunisia
| | - Sameh Marzouk
- Department of Internal Medicine, Hedi Chaker Hospital, Sfax, Tunisia
| | - Zouheir Bahloul
- Department of Internal Medicine, Hedi Chaker Hospital, Sfax, Tunisia
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107
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Zhang X, Ruan J, Tang Z, Dai R, Lv Z. Scattered Reddish-brown Nodules on the Head in an Elderly Man: A Quiz. Acta Derm Venereol 2023; 103:adv00857. [PMID: 36172701 PMCID: PMC9903146 DOI: 10.2340/actadv.v102.2453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/12/2022] [Indexed: 02/02/2023] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Xuetong Zhang
- Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Jiali Ruan
- Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Zhuangli Tang
- Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Ru Dai
- Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Zhongfa Lv
- Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China.
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108
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Portegys J, Heidemeier A, Rosenwald A, Gernert M, Fröhlich M, Hueper S, Strunz PP, Rasche L, Schmalzing M. Erdheim-Chester disease with Rosai-Dorfman-like lesions: treatment with methotrexate, anakinra and upadacitinib. RMD Open 2023; 9:rmdopen-2022-002852. [PMID: 36693681 PMCID: PMC9884847 DOI: 10.1136/rmdopen-2022-002852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/29/2022] [Indexed: 01/26/2023] Open
Abstract
Erdheim-Chester disease (ECD) is a non-Langerhans cell histiocytosis characterised by clonal expansion of histiocytes in various organs. These induce an inflammatory environment, which leads to damage of the affected areas. Recently, a new disease entity was proposed encompassing key features of ECD but also of Rosai-Dorfman-Destombes disease, another histiocytosis. Mitogen-activated protein kinase kinase 1 (MAP2K1) mutations seem to present a specific genetic lesion for this subtype.Here, we describe a case of this new disease entity with clinical, radiological and genetic findings compatible with ECD but histological findings compatible with Rosai-Dorfman-Destombes disease. In particular, there were intraabdominal and retroperitoneal lesions, which tested positive for a (c.167A>C; p.Q56P) mutation of the MAP2K1 gene. On histological examination, S100-positive, giant histiocytes with focal emperipolesis of haematological cells in addition to infiltration by lymphocytes and granulocytes were seen.As described for this rare variant of ECD, there was also bilateral testicular infiltration. We also describe a manifestation of oligoarthritis in this patient with ECD.The patient was treated with methotrexate and prednisolone. While radiological response to this regime was excellent, arthritis persisted. We added anakinra, which induced a response of the arthritis for more than a year. Due to treatment failure therapy was switched to upadacitinib, which induced a remission of the arthritis as well.This case adds a rare phenotype to an already rare presentation of ECD. The patient responded to immunosuppressive therapy.
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Affiliation(s)
- Jan Portegys
- Department of Internal Medicine II, Rheumatology/Clinical Immunology, University of Würzburg, Wuerzburg, Germany
| | - Anke Heidemeier
- Institute for diagnostic and interventional radiology, University of Würzburg, Wuerzburg, Germany
| | | | - Michael Gernert
- Department of Internal Medicine II, Rheumatology/Clinical Immunology, University of Würzburg, Wuerzburg, Germany
| | - Matthias Fröhlich
- Department of Internal Medicine II, Rheumatology/Clinical Immunology, University of Würzburg, Wuerzburg, Germany,Department of Internal Medicine II, Rheumatology and Clinical Immunology, University of Würzburg, Wuerzburg, Germany
| | - Sebastian Hueper
- Department of Internal Medicine II, Rheumatology/Clinical Immunology, University of Würzburg, Wuerzburg, Germany
| | - Patrick Pascal Strunz
- Department of Internal Medicine II, Rheumatology/Clinical Immunology, University of Würzburg, Wuerzburg, Germany
| | - Leo Rasche
- Department of Internal Medicine II, University of Würzburg, Wuerzburg, Germany
| | - Marc Schmalzing
- Department of Internal Medicine II, Rheumatology/Clinical Immunology, University of Würzburg, Wuerzburg, Germany
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109
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Brink A, Hlongwa KN, More S. The Impact of PET/CT on Paediatric Oncology. Diagnostics (Basel) 2023; 13:diagnostics13020192. [PMID: 36673002 PMCID: PMC9857884 DOI: 10.3390/diagnostics13020192] [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: 10/31/2022] [Revised: 12/01/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023] Open
Abstract
This review paper will discuss the use of positron emission tomography/computed tomography (PET/CT) in paediatric oncology. Functional imaging with PET/CT has proven useful to guide treatment by accurately staging disease and limiting unnecessary treatments by determining the metabolic response to treatment. 18F-Fluorodeoxyglucose (2-[18F]FDG) PET/CT is routinely used in patients with lymphoma. We highlight specific considerations in the paediatric population with lymphoma. The strengths and weaknesses for PET/CT tracers that compliment Meta-[123I]iodobenzylguanidine ([123I]mIBG) for the imaging of neuroblastoma are summarized. 2-[18F]FDG PET/CT has increasingly been used in the staging and evaluation of disease response in sarcomas. The current recommendations for the use of PET/CT in sarcomas are given and potential future developments and highlighted. 2-[18F]FDG PET/CT in combination with conventional imaging is currently the standard for disease evaluation in children with Langerhans-cell Histiocytosis (LCH) and the non-LCH disease spectrum. The common pitfalls of 2-[18F]FDG PET/CT in this setting are discussed.
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110
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Yoshida M, Zoshima T, Hara S, Takahashi Y, Nishioka R, Ito K, Mizuhima I, Inoue D, Nakada S, Kawano M. Case report: Rosai-Dorfman disease with rare extranodal lesions in the pelvis, heart, liver and skin. Front Oncol 2023; 12:1083500. [PMID: 36686758 PMCID: PMC9846742 DOI: 10.3389/fonc.2022.1083500] [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: 10/29/2022] [Accepted: 12/14/2022] [Indexed: 01/06/2023] Open
Abstract
Rosai-Dorfman disease (RDD), a rare form of non-Langerhans cell histiocytosis, can involve systemic extranodal lesions. Skin lesions are the most common, whereas intrapelvic, cardiac, and hepatic lesions are infrequent. The present study describes a 74-year-old woman with multiple extranodal lesions in the pelvis, heart, liver, and skin that were successfully treated with glucocorticoid therapy. She had experienced fever and persistent inflammation without cervical lymphadenopathy for several months and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) showed abnormal FDG uptake in the left cheek; cervical, axillary, inguinal lymph nodes; periatrium; and pelvis. She was diagnosed with RDD based on skin and pelvic biopsies. Although this was an atypical case without bilateral cervical lymphadenopathy, the FDG-PET detection of inflammatory lesions led to selection of suitable biopsy sites, and pathological examination led to a correct diagnosis. Findings in this patient indicate that RDD can present with an atypical distribution of infrequent extranodal lesions, with attention required to prevent a delayed diagnosis.
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Affiliation(s)
- Misaki Yoshida
- Department of Rheumatology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Takeshi Zoshima
- Department of Rheumatology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Satoshi Hara
- Department of Rheumatology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Yoshinori Takahashi
- Department of Rheumatology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Ryo Nishioka
- Department of Rheumatology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kiyoaki Ito
- Department of Rheumatology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Ichiro Mizuhima
- Department of Rheumatology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Satoko Nakada
- Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Mitsuhiro Kawano
- Department of Rheumatology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan,*Correspondence: Mitsuhiro Kawano,
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111
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Bhargava P, Choudhary GR, Elhence P, Jena R. Extranodal Rosai-Dorfman disease: A rare mimicker of metastatic renal cell carcinoma. Indian J Urol 2023; 39:70-72. [PMID: 36824105 PMCID: PMC9942222 DOI: 10.4103/iju.iju_265_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/24/2022] [Accepted: 11/28/2022] [Indexed: 02/25/2023] Open
Abstract
A 29-year-old female presented with the history of pain in the abdomen and a palpable lump in the right hypochondrium, lumbar, and the umbilical regions for the past 2 months. On evaluation with contrast-enhanced computed tomography (CECT) and positron emission tomography CT, she was found to have a heterogeneously enhancing mass entirely replacing the mid and the lower pole of the right kidney, the pelvis, and the upper ureter with loss of fat planes with the inferior vena cava, psoas muscle, and the hepatic flexure, along with pericardial deposits and soft tissue lesions at multiple paravertebral regions and the right thigh. Owing to a high suspicion of metastatic renal cell carcinoma (RCC), a right cytoreductive nephrectomy was performed. Histopathology revealed extranodal Rosai-Dorfman disease, which was mimicking a metastatic RCC on imaging. The patient was started on oral steroids to control the distant lesions and to prevent progression of the disease and is doing well at follow up.
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Affiliation(s)
| | | | - Poonam Elhence
- Department of Pathology, AIIMS, Jodhpur, Rajasthan, India
| | - Rahul Jena
- Department of Urology, AIIMS, Jodhpur, Rajasthan, India
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112
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Cronin C, McLaughlin R, Lane L, Brett FM, Jansen M, Bermingham N, Wyse G, Grogan L, Morris PG, O’Reilly S. Case report: BRAF-inhibitor therapy in BRAF-mutated primary CNS tumours including one case of BRAF-mutated Rosai-Dorfman disease. Front Med (Lausanne) 2022; 9:1070828. [PMID: 36619621 PMCID: PMC9813211 DOI: 10.3389/fmed.2022.1070828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
BRAF V600E oncogene mutations have been reported in multiple central nervous system (CNS) tumor types, and emerging evidence supports the use of targeted therapy in BRAF-mutated gliomas. BRAF oncogene mutations have been recently identified in Rosai-Dorfman disease (RDD)-a rare non-Langerhans cell histiocytosis. This series describes three patients from two neurosurgical centers in Ireland with BRAF V600E-mutated CNS tumors. The study participants include a 19-year-old male patient with ganglioglioma with anaplastic features, a 21-year-old male patient with CNS involvement of RDD, and a 28-year-old female patient with ganglioglioma with anaplastic features. Two patients received radiation with concurrent temozolomide before BRAF-targeted therapy. This case series describes clinical and radiological responses to BRAF-targeted therapy in BRAF V600E-mutated gliomas across multiple tumor grades and is only the second published report of response to targeted therapy in BRAF-mutated RDD. The durability of disease control with BRAF-targeted therapy was generally superior to that achieved with chemoradiation; one patient has experienced ongoing disease control for 5 years. The reported case of treatment response in BRAF-mutated RDD supports the strategy of genotyping and utilization of targeted therapy in this rare disease. The optimal sequencing of BRAF-targeted therapy in BRAF-mutated gliomas/glioneuronal tumors remains unclear, and further prospective studies are required to guide the use of genome-matched therapy in this patient population.
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Affiliation(s)
- Christopher Cronin
- 1Department of Medical Oncology, Cork University Hospital, Cork, Ireland,*Correspondence: Christopher Cronin,
| | - Ronan McLaughlin
- 2Department of Medical Oncology, Beaumont Hospital, Dublin, Ireland
| | - Louise Lane
- 3Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | | | - Michael Jansen
- 4Department of Neuropathology, Cork University Hospital, Cork, Ireland
| | - Niamh Bermingham
- 4Department of Neuropathology, Cork University Hospital, Cork, Ireland
| | - Gerald Wyse
- 5Department of Radiology, Cork University Hospital, Cork, Ireland
| | - Liam Grogan
- 2Department of Medical Oncology, Beaumont Hospital, Dublin, Ireland
| | | | - Seamus O’Reilly
- 1Department of Medical Oncology, Cork University Hospital, Cork, Ireland
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113
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Gogia P, Tanni F, Coca-Guzman J, Chen N, Huang Y. Case report: A rare case of Rosai-Dorfman-Destombes disease after the COVID-19 infection. Front Med (Lausanne) 2022; 9:1073767. [PMID: 36600887 PMCID: PMC9806133 DOI: 10.3389/fmed.2022.1073767] [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: 10/18/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to cause immune dysregulation and, therefore, has varied and often rare presentations. Rosai-Dorfman-Destombes disease (RDD) is an unusual non-Langerhans cell (non-LC) histiocytosis presenting with massive lymphadenopathy and various systemic symptoms. A 55-year-old Asian-American woman with no significant medical history or recent use of new drugs initially presented with cervical lymphadenopathy and urticarial rash 1 week after receiving the COVID-19 messenger RNA (mRNA) vaccine (Moderna, mRNA-1273) against SARS-CoV-2. The biopsy of the skin rash was consistent with a drug reaction. Approximately 2 months later, she developed mild flu-like symptoms and was diagnosed with a COVID-19 infection. Her symptoms were mild and self-resolving. Approximately 3 months later, she developed a generalized patchy erythematous rash on the face and the body that gradually worsened; diffuse lymphadenopathy involving the bilateral cervical, axillary, and inguinal areas; and constitutional symptoms. Laboratory results were consistent with lymphopenia, anemia, and an elevated sedimentation rate. Supraclavicular lymph node biopsy showed Rosai-Dorfman disease with a marked polyclonal plasmacytosis. She was started on a tapering dose of corticosteroids and showed clinical improvements over the next few weeks. Herein, we present a rare case of a histiocytic disorder that developed after contracting the SARS-COV2 infection in the event of receiving a recent mRNA COVID vaccination.
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Affiliation(s)
- Pooja Gogia
- Department of Hematology and Oncology, Maimonides Medical Center, Brooklyn, NY, United States,*Correspondence: Pooja Gogia
| | - Fahmina Tanni
- Department of Hematology and Oncology, Maimonides Medical Center, Brooklyn, NY, United States
| | - Juan Coca-Guzman
- Department of Pathology, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
| | - Neil Chen
- Department of Hematology and Oncology, Maimonides Medical Center, Brooklyn, NY, United States,Department of Pathology, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
| | - Yiwu Huang
- Department of Hematology and Oncology, Maimonides Medical Center, Brooklyn, NY, United States
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Perforating Colitis Secondary to Immune Checkpoint Inhibitor Use in a Patient With Pericolonic Involvement by Rosai-Dorfman Disease. ACG Case Rep J 2022; 9:e00900. [PMID: 36561494 PMCID: PMC9762925 DOI: 10.14309/crj.0000000000000900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 08/31/2022] [Accepted: 09/16/2022] [Indexed: 12/24/2022] Open
Abstract
Recently, the use of immunotherapy has increased substantially for the treatment of several malignancies. It is associated with several gastrointestinal adverse events; however, severe complications such as intestinal perforation are rare. We present a 75-year-old man with metastatic melanoma, presented with profuse diarrhea and abdominal pain, after ipilimumab and nivolumab administration. Shortly after, he developed fulminant colitis and intestinal perforation and was found to have concurrent Rosai-Dorfman disease of pericolonic lymph nodes. With the increasing use of immunotherapy, reporting of serious adverse events and their mimics is essential. In addition, further studies are required to investigate whether an association exists between Rosai-Dorfman disease and immunotherapy.
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Bone Marrow Infiltration in Rosai-Dorfman Disease. Case Rep Hematol 2022; 2022:3420311. [PMID: 36568338 PMCID: PMC9779991 DOI: 10.1155/2022/3420311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare and benign nonLangerhans cell histiocytosis. RDD commonly affects children and young adults typically presenting with massive, painless, and bilateral cervical lymphadenopathy. Extranodal involvement is present in about 40% of cases, and bone marrow infiltration is rare and unusual. RDD prognosis is usually good, however, involvement of bone marrow is associated with poor prognosis. We report a case of RDD with bone marrow involvement occurring in a 5-year-old female. She was admitted for asthenia, gingival bleeding, and diffuse bone pain without fever. Physical examination showed pallor, petechiae over the abdomen, painless and bilateral cervical lymphadenopathy, and several bony nodules, without splenomegaly or hepatomegaly. Cell blood count revealed microcytic hypochromic anemia with thrombocytopenia. Bone marrow aspiration showed infiltration by large histiocytes with hypochromatic nuclei and abundant vacuolated cytoplasm without emperipolesis. Biopsies of bone marrow, lymph node, and bone revealed immunohistochemical features of RDD: the histiocytes were positive for CD68 and S100 protein, but negative for CD1a. The patient initially received symptomatic treatment. One week after admission, she died of septic shock before the final establishment of RDD diagnosis. This case report highlights that bone marrow involvement in RDD is rare and associated with poor prognosis. We also aim to emphasize the obligation of bone marrow exploration in patients with RDD and presenting cytopenias in order to make an early diagnosis of bone marrow infiltration.
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Gallo A, Macerola N, Ibba F, Contegiacomo A, Montalto M. A rare case of abdominal lymphadenopathy and fever. Intern Emerg Med 2022:10.1007/s11739-022-03167-7. [PMID: 36495420 PMCID: PMC9739337 DOI: 10.1007/s11739-022-03167-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Antonella Gallo
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli 1, 00168, Rome, Italy.
| | - Noemi Macerola
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli 1, 00168, Rome, Italy
| | - Francesca Ibba
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli 1, 00168, Rome, Italy
| | - Andrea Contegiacomo
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli 1, 00168, Rome, Italy
| | - Massimo Montalto
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli 1, 00168, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Fabozzi F, De Vito R, Gaspari S, Leone F, Delvecchio M, Agolini E, Galaverna F, Mastronuzzi A, Pagliara D, De Ioris MA. Case report: A new pathogenic variant of LRBA deficiency with a complex phenotype and Rosai-Dorfman disease. Front Immunol 2022; 13:944810. [PMID: 36569874 PMCID: PMC9780374 DOI: 10.3389/fimmu.2022.944810] [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: 05/15/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022] Open
Abstract
We reported a new pathogenic variant of LRBA deficiency with a complex phenotype-neonatal diabetes, very early-onset inflammatory bowel disease, and polyarthritis-who presented with lymph node enlargement. A case of Rosai-Dorfman's disease (RDD) was confirmed. The occurrence of an RDD lesion in LRBA-deficiency has never been reported so far.
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Affiliation(s)
- Francesco Fabozzi
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy,Department of Pediatrics, University of Tor Vergata, Rome, Italy
| | - Rita De Vito
- Department of Pathology, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Stefania Gaspari
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Fabrizio Leone
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Emanuele Agolini
- Laboratory of Medical Genetics, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Federica Galaverna
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Angela Mastronuzzi
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Daria Pagliara
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Maria Antonietta De Ioris
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy,*Correspondence: Maria Antonietta De Ioris,
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Abeykoon JP, Rech KL, Young JR, Ravindran A, Ruan GJ, Dasari S, Morlote DM, King RL, Rummage C, Zanwar S, Acosta-Medina AM, Tobin WO, Shah MV, Bennani NN, Vassallo R, Ryu JH, Koster MJ, Davidge-Pitts CJ, Witzig TE, Goyal G, Go RS. Outcomes After Treatment With Cobimetinib in Patients With Rosai-Dorfman Disease Based on KRAS and MEK Alteration Status. JAMA Oncol 2022; 8:1816-1820. [PMID: 36201194 PMCID: PMC9539729 DOI: 10.1001/jamaoncol.2022.4432] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/11/2022] [Indexed: 11/14/2022]
Abstract
Importance Rosai-Dorfman disease (RDD) is a rare histiocytic neoplasm with recent studies showing alterations in the MAPK pathway, most commonly in the KRAS and MEK genes in about 40% of patients. Reports on the use of MEK-inhibitor therapy in RDD have been limited to small case studies. There are no approved treatments for this neoplasm, and therefore patients with RDD need efficacious treatments. Objective To study the outcomes after treatment with cobimetinib based on MAPK pathway alterations in patients with RDD. Design, Setting, and Participants This retrospective cohort study conducted at 2 tertiary care centers included patients with RDD who underwent treatment with cobimetinib between January 1, 2013, and December 1, 2021. Cobimetinib was administered at a dosage of 20 to 60 mg orally once daily as a single agent for 21 days in a 28-day cycle. Pathology was centrally reviewed. Response assessment was centrally conducted and was based on the established positron emission radiography response criteria used for clinical trials of targeted therapies in histiocytosis. Main Outcomes and Measures Main outcomes were overall response rate (ORR), progression-free survival (PFS), adverse events (AEs) of cobimetinib in the entire cohort, and ORRs and PFS based on MAPK pathway alterations in patients with RDD. Results A total of 16 patients (median [range] age at cobimetinib initiation, 57 [31-74] years; 11 [69%] women) were included in the study. The median follow-up duration was 19.0 months (95% CI, 8.4-27.8 months). The ORR was 63% (n = 10), including 5 complete responses and 5 partial responses. Somatic alterations in the KRAS or MEK genes were detected in 8 (50%) patients. Patients with KRAS or MEK alterations had significantly higher ORR (88% vs 38%; P = .03), deeper responses (complete responses among responders: 71% vs 0%; P = .002), and better PFS (at 1 year, 100% vs 29% were free from progression or death, respectively; P < .001) compared with those without such alterations. Grade 2 or higher AEs occurred in 12 (75%) patients, and 9 (56%) required dose reduction or temporary/permanent treatment discontinuation due to AEs. Conclusions and Relevance In this cohort study, treatment with cobimetinib was associated with positive outcomes in KRAS- or MEK-variant RDD. However, AEs requiring dose modifications were common.
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Affiliation(s)
- Jithma P. Abeykoon
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Karen L. Rech
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Jason R. Young
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Aishwarya Ravindran
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Gordon J. Ruan
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Surendra Dasari
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | - Rebecca L. King
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Claire Rummage
- Hematology/Oncology Clinical Pharmacist, University of Alabama at Birmingham
| | - Saurabh Zanwar
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Aldo M. Acosta-Medina
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Mithun V. Shah
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - N. Nora Bennani
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Robert Vassallo
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jay H. Ryu
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | | | | | - Thomas E. Witzig
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Gaurav Goyal
- Division of Hematology-Oncology, University of Alabama at Birmingham
- Research Collaborator (limited tenure), Division of Hematology, Mayo Clinic, Rochester, Minnesota
| | - Ronald S. Go
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
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68Ga-FAPI and 18F-FDG PET/CT Images of a Patient With Rosai-Dorfman Disease With Liver Involvement. Clin Nucl Med 2022; 47:1079-1081. [PMID: 36342795 DOI: 10.1097/rlu.0000000000004367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
ABSTRACT Rosai-Dorfman disease is a rare non-Langerhans cell histiocytosis that is histopathologically characterized by the accumulation of CD68-positive and S100-positive histiocytes. The pathological changes are mostly discovered in lymph nodes. We report a case of Rosai-Dorfman disease with liver and bone marrow involvement. In this case, 18F-FDG PET/CT revealed FDG avidity in multiple lymph nodes, liver, and bone marrow. 68Ga-FAPI PET/CT showed higher uptake of 68Ga-FAPI than that of 18F-FDG in the same lesions. The findings of 68Ga-FAPI PET/CT in this patient highlighted the potential value of 68Ga-FAPI for staging in Rosai-Dorfman disease.
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120
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Gonzales MR, White JC, Mangum DS, Powell JL. Sporadic extranodal Rosai-Dorfman-Destombes disease treated with tocilizumab. Pediatr Blood Cancer 2022; 69:e29754. [PMID: 35484989 DOI: 10.1002/pbc.29754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/12/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Manuel R Gonzales
- Department of Pediatrics, Nemours Children's Hospital - Delaware, Wilmington, Delaware, USA
| | - Jason C White
- Nemours Center for Cancer and Blood Disorders, Nemours Children's Hospital - Delaware, Wilmington, Delaware, USA
| | - D Spencer Mangum
- Nemours Center for Cancer and Blood Disorders, Nemours Children's Hospital - Delaware, Wilmington, Delaware, USA
| | - Jonathan L Powell
- Nemours Center for Cancer and Blood Disorders, Nemours Children's Hospital - Delaware, Wilmington, Delaware, USA
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Mitchell HR, Applebaum AJ, Lynch KA, Reiner AS, Atkinson TM, Buthorn JJ, Sigler AS, Bossert D, Brewer K, Corkran J, Fournier D, Panageas KS, Diamond EL. Challenges and positive impact of rare cancer caregiving: A mixed-methods study of caregivers of patients with Erdheim-Chester disease and other histiocytic neoplasms. EClinicalMedicine 2022; 54:101670. [PMID: 36188434 PMCID: PMC9519468 DOI: 10.1016/j.eclinm.2022.101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The importance of deriving benefit and meaning has been identified among cancer caregivers, but this has yet to be examined in the context of rare cancers. We sought to characterize unmet needs and experiences of caregivers of patients with Erdheim-Chester disease (ECD) and other histiocytic neoplasms (HN) and to identify factors associated with finding benefit and meaning-making in providing care for patients with rare cancers. METHODS Caregivers of patients with ECD and other HN completed quantitative surveys. Linear univariable regression modeling examined associations between unmet needs, social and family support, and intolerance of uncertainty with benefit finding and meaning-making. A subset participated in qualitative interviews assessing experiences of rare cancer caregiving that were analyzed with applied thematic analysis (NCT039900428). FINDINGS Of caregivers (N = 92, M = 54 years old, 68% female) of patients with ECD (75%) and other HN (25%), 78% reported moderately or severely unmet support needs, most frequently informational (58%) and psychological/emotional (66%) needs. Caregivers with unmet informational, psychological/emotional, and social support needs, difficulty tolerating uncertainty, a longer duration of the patient's illness, lower social support, more family conflict, and higher anxiety and depression symptoms demonstrated less benefit finding and meaning-making (ps <.05). Qualitative interviews (N = 19) underscored information and support needs and the capacity to derive meaning from caregiving. INTERPRETATION Rare cancer caregivers report numerous unmet information and support needs, needs that arise from disease rarity itself and which are associated with diminished capacity for deriving benefit and meaning from caregiving. Findings highlight targets for interventions to improve support for caregivers with HN and other rare cancers. FUNDING NIH P30 CA008748 (PI: Craig Thompson, MD), NIH T32 CA009461 (H.M.; PI: Jamie Ostroff, PhD), Frame Family Fund (E.L.D.), Applebaum Foundation (E.L.D.).
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Affiliation(s)
- Hannah-Rose Mitchell
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Allison J. Applebaum
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Kathleen A. Lynch
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Anne S. Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Thomas M. Atkinson
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Justin J. Buthorn
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Allison S. Sigler
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Dana Bossert
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Kathleen Brewer
- Erdheim-Chester Disease Global Alliance, DeRidder, LA, United States
| | - Jessica Corkran
- Erdheim-Chester Disease Global Alliance, DeRidder, LA, United States
| | | | - Katherine S. Panageas
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Eli L. Diamond
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Corresponding author at: Department of Neurology, Memorial Sloan Kettering Cancer Center 160 East 53rd St. Second Floor Neurology, New York, NY 10022 United States.
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Moore SM, Astle J, Shay SG. Cervical Lymphadenopathy and Airway Masses in a Child. JAMA Otolaryngol Head Neck Surg 2022; 149:2798549. [PMID: 36355353 DOI: 10.1001/jamaoto.2022.3576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
A previously healthy 12-year-old boy presented with a 3-month history of nasal obstruction, progressive dysphonia, recurrent deep neck abscesses, and tender, bulky cervical lymphadenopathy. What is your diagnosis?
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Affiliation(s)
| | - John Astle
- Department of Pathology and Laboratory Medicine, Medical College of Wisconsin, Milwaukee
| | - Sophie G Shay
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee
- Division of Pediatric Otolaryngology, Children's Wisconsin, Milwaukee
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Zhang X, Yin W, Guo Y, He Y, Jiang Z, Li Y, Xie B, Zhang S, Jiang X, Liu Q, Yuan J. Rosai–Dorfman disease of the central nervous system: A clinical, radiological, and prognostic study of 12 cases. Front Oncol 2022; 12:1013419. [PMID: 36408161 PMCID: PMC9669081 DOI: 10.3389/fonc.2022.1013419] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Background Rosai–Dorfman disease (RDD) is a rare benign non-Langerhans cell histiocytic proliferative disease. RDD with central nervous system (CNS) involvement (CNS-RDD) is extremely rare. Its etiology is unclear, and there are no consensus recommendations for its treatment. More studies are needed to elucidate the clinical and radiological manifestations and prognosis of CNS-RDD. Methods From January 2012 to June 2022, 12 patients with CNS-RDD (intracranial or spinal) were retrospectively evaluated, including collecting clinical data, imaging data, and pathological findings; summarizing imaging characteristics; and conducting follow-up studies on CND-RDD patient treatment and prognosis. Results Twelve CNS-RDD patients (nine male and three female patients, aged 12–67 years) were enrolled in this study. Nine patients represented convex and/or skull base RDD (eight with edema, six with lobulation and/or pseudopodium sign, four with multiple intracranial lesions), two patients had parenchymal RDD, and one patient had spinal cord subdural lesions. Symptoms of patients would vary according to the locations of the lesion, including but not limited to headaches, dizziness, seizures, cranial nerve dysfunction, and visual impairment. The immunohistochemistry of RDD showed positive expression of S100 and CD68 but not CD1a. Total resection (n = 7), subtotal resection (n = 3), partial resection (n = 1), and stereotaxic biopsy (n = 1) were achieved, respectively. A combination of chemotherapy plus steroid therapy was performed on two patients (relapsing case and residual lesion) and showed a remarkable effect. Conclusion CNS-RDD, as a rare disease, presents a significant diagnostic challenge for clinicians. Solitary CNS-RDD are easily misdiagnosed as meningioma. However, when the MRI imaging of the disease represents dura-based masses with significant edema, homogeneous enhancement, lobulation, and/or pseudopodium sign, we should consider it might be the CNS-RDD. Surgery is an important and effective therapy for CNS-RDD. Steroids and chemotherapy are safe and effective for the postoperative treatment of relapsing cases or residual lesions.
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Affiliation(s)
- Xingshu Zhang
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Wen Yin
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Youwei Guo
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Yi He
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Zhipeng Jiang
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Yuzhe Li
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Bo Xie
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Seng Zhang
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Xingjun Jiang
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Qing Liu
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Jian Yuan
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
- *Correspondence: Jian Yuan,
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Elbaz Younes I, Sokol L, Zhang L. Rosai-Dorfman Disease between Proliferation and Neoplasia. Cancers (Basel) 2022; 14:5271. [PMID: 36358690 PMCID: PMC9654168 DOI: 10.3390/cancers14215271] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 09/20/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare myeloproliferative disorder of histiocytes with a broad spectrum of clinical manifestations and peculiar morphologic features (accumulation of histiocytes with emperipolesis). Typically, the patient with RDD shows bilateral painless, massive cervical lymphadenopathy associated with B symptoms. Approximately 43% of patients presented with extranodal involvement. According to the 2016 revised histiocytosis classification, RDD belongs to the R group, including familial and sporadic form (classical nodal, extranodal, unclassified, or RDD associated with neoplasia or immune disease). Sporadic RDD is often self-limited. Most RDD needs only local therapies. Nevertheless, a small subpopulation of patients may be refractory to conventional therapy and die of the disease. Recent studies consider RDD a clonal neoplastic process, as approximately 1/3 of these patients harbor gene mutations involving the MAPK/ERK pathway, e.g., NRAS, KRAS, MAP2K1, and, rarely, the BRAF mutation. In addition to typical histiocytic markers (S100/fascin/CD68/CD163, etc.), recent studies show that the histiocytes in RDD also express BCL-1 and OCT2, which might be important in pathogenesis. Additionally, the heterozygous germline mutation involving the FAS gene TNFRSF6 is identified in some RDD patients with an autoimmune lymphoproliferative syndrome type Ia. SLC29A3 germline mutation is associated with familial or Faisalabad histiocytosis and H syndrome.
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Affiliation(s)
| | - Lubomir Sokol
- Department of Hematology and Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Ling Zhang
- Department of Pathology, Moffitt Cancer Center, Tampa, FL 33612, USA
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Kiruthiga KG, Younes S, Natkunam Y. Strong Coexpression of Transcription Factors PU.1 and Oct-2 in Rosai-Dorfman Disease. Am J Clin Pathol 2022; 158:672-677. [PMID: 36239684 DOI: 10.1093/ajcp/aqac119] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/23/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Rosai-Dorfman disease (RDD) is a rare disorder characterized by the accumulation of large S100 protein-positive histiocytes that typically exhibit emperipolesis. The recently reported expression of Oct-2 in RDD histiocytes led us to explore whether PU.1, a transcription factor that is required for monocyte and B-cell development, could similarly function as a diagnostic marker in RDD. METHODS We evaluated the expression of PU.1 and Oct-2 using immunohistochemistry in 19 patients diagnosed with RDD involving nodal, extranodal, and cutaneous sites. RESULTS Both PU.1 and Oct-2 were positive in all cases studied, with a strong intensity of staining in 84% of cases in which more than 50% of the lesional cells were positive. In three patients, both markers showed weak to moderate intensity of staining. Two patients had concomitant RDD and Langerhans cell histiocytosis in which PU.1 stained both types of histiocytes while Oct-2 stained only the RDD component. CONCLUSIONS PU.1 emerged as a robust marker with crisp nuclear staining in RDD histiocytes as well as in engulfed inflammatory cells. Strong coexpression of PU.1 and Oct-2 is a useful diagnostic marker in differentiating histiocytic/dendritic cell proliferations.
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Affiliation(s)
| | - Sheren Younes
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Yasodha Natkunam
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
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Terzi A, Sercan Ç, Şahintürk F. A unique case of isolated thoracic spinal Rosai-Dorfman disease related to IgG4. Neuropathology 2022; 43:176-180. [PMID: 36226609 DOI: 10.1111/neup.12872] [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: 04/05/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022]
Abstract
Rosai-Dorfman disease (RDD) is a rare benign histiocytosis usually characterized by massive cervical lymphadenopathy and systemic manifestations. Extranodal, especially spinal involvement, is extremely rare. Our case was deemed worthy of presentation because it was the first reported isolated case of spinal RDD related to IgG4 and mimicked meningioma clinically and radiologically. A case with an intradural extramedullary mass causing neurological compression findings in the thoracic spinal region and radiologically mimicking meningioma is presented. In the histomorphological examination of the resection material, polymorphonuclear leukocytes in the dura, histiocytes showing emperipolesis, an increase in collagenized fibrous connective tissue, and intense lymphoplasmacytic cell infiltration accompanied by obliterative phlebitis were observed. Immunohistochemically, the histiocytic cells were found to be S-100 protein, CD68, and CD163 positive and CD1a and langerin negative, and more than half of the plasma cells were immunoglobulin-G4 (IgG4) positive. Although rare, RDD or IgG4-related meningeal disease should be considered in the differential diagnosis of dural-based spinal masses that radiologically suggest meningioma. The pathologist should be aware that these two histopathological entities may coexist. To our knowledge, this is the first case of "isolated spinal RDD related to IgG4" reported in the literature.
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Affiliation(s)
- Ayşen Terzi
- Department of Pathology, Baskent University School of Medicine, Ankara, Turkey
| | - Çiğdem Sercan
- Department of Pathology, TOBB ETU School of Medicine, Ankara, Turkey
| | - Fikret Şahintürk
- Department of Neurosurgery, Baskent University School of Medicine, Ankara, Turkey
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Abdela SG, Mengesha CA. Rosai-Dorfman disease mimicking gastrointestinal tuberculosis and fungal sinusitis: A case report. Radiol Case Rep 2022; 17:4730-4733. [PMID: 36212757 PMCID: PMC9539622 DOI: 10.1016/j.radcr.2022.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 11/07/2022] Open
Abstract
Every organ can be affected by Rosai-Dorfman disease, the most common being skin and soft tissue, bone and upper respiratory tract. Here we present a Rosai-Dorfman disease patient who manifested with multiple organ involvement. A 33-year-old male presented with multiple joint pain, diarrhea, a purulent nasal discharge and sinus pain. After having serials of investigations he was misdiagnosed as having tuberculosis and fungal sinusitis. Finally, cytology from lymph node aspiration suggested Rosai-Dorfman disease. The sino nasal presentation of Rosai-Dorfman disease can be misdiagnosed as fungal sinusitis and the gastrointestinal manifestation can mimic gastrointestinal tuberculosis. Diffuse joint involvement could also be an initial manifestation of Rosai-Dorfman disease.
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Affiliation(s)
- Seid Getahun Abdela
- Department of Internal Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia,Corresponding author.
| | - Chalew Abebe Mengesha
- Department of Radiology, College of Medicine and Health sciences, University of Gondar, Gondar, Ethiopia
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128
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Abstract
Histiocytic disorders of childhood represent a wide spectrum of conditions that share the common histologic feature of activated or transformed "histiocytes." Langerhans cell histiocytosis (LCH) is the most common, with an incidence of approximately 5 per million children. LCH may be difficult to distinguish from more ubiquitous causes of skin rashes, bone pain, or fever. Current chemotherapy fails to cure more than 50% of children with multifocal disease, and treatment failure is associated with increased risks of long-term sequelae. Somatic activating mitogen-activated protein kinase (MAPK) pathway-activating mutations (most often BRAFV600E) have been identified in hematopoietic precursors in patients with LCH. Opportunities to improve outcomes with targeted therapies are under investigation. Juvenile xanthogranuloma (JXG) and Rosai-Dorfman disease (RDD) are less common than LCH and are distinguished by specific histologic and clinical features. Recurrent MAPK pathway gene mutations are also identified in JXG and RDD. In many cases, these conditions spontaneously resolve, but disseminated disease can be fatal. Although there has been historic debate regarding the nature of these conditions as inflammatory versus neoplastic, LCH, JXG, and RDD are now considered myeloid neoplastic disorders. In contrast, hemophagocytic lymphohistiocytosis (HLH) is clearly a disorder of immune dysregulation. HLH is characterized by extreme immune activation driven by hyperactivated T cells. HLH arises in approximately 1 child per million and is nearly universally fatal without prompt recognition and immune suppression. Outcomes of treated children are poor, with approximately 60% survival. Emapalumab, which targets interferon-γ signaling, was recently approved for patients with recurrent or refractory HLH, and additional cytokine-directed therapies are under investigation.
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Affiliation(s)
- Olive S Eckstein
- Texas Children's Hospital Cancer and Hematology Centers, Section of Pediatric Hematology and Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Jennifer Picarsic
- Cincinnati Children's Hospital, Department of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, OH
| | - Carl E Allen
- Texas Children's Hospital Cancer and Hematology Centers, Section of Pediatric Hematology and Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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Maniar YM, Meyer CF, Sharp M, Zambidis ET, Qaysi NA, Horne AJ. Rosai-Dorfman Disease Presenting as Massive Mediastinal Lymphadenopathy in an Elderly Man. ANNALS OF INTERNAL MEDICINE. CLINICAL CASES 2022; 1:e220539. [PMID: 36683654 PMCID: PMC9850576 DOI: 10.7326/aimcc.2022.0539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We present a patient case of a 73-year-old man with new-onset substernal chest pain and B symptoms, found on computed tomography imaging to have massive mediastinal lymphadenopathy of more than 6 cm. Positron emission tomography imaging revealed fluorodeoxyglucose-avid nodes further extending to the axillary, abdominal, and inguinal regions. After a broad patient work-up for infectious, malignant, and rheumatic causes, he was ultimately diagnosed with Rosai-Dorfman disease, a rare histiocytic neoplasm, by excisional lymph node biopsy.
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Affiliation(s)
- Yash M. Maniar
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Christian F. Meyer
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michelle Sharp
- Division of Pulmonary and Critical Care, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elias T. Zambidis
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nada A.I Qaysi
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alexandra J. Horne
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Francis JH, Gobin YP, Diamond EL. Treatment-Refractory Nodular Scleritis. JAMA Ophthalmol 2022; 140:2796320. [PMID: 36107407 DOI: 10.1001/jamaophthalmol.2022.3591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
A 59-year-old woman with a 5-year history of intermittent bilateral uveitis and scleritis presented with painful left uveitis and an episcleral nodule shown to be a uveal-episcleral lesion on ultrasound biomicroscopy. Biopsy of a nasal sinus mass 3 years earlier showed a histiocytic infiltrate with emperipolesis, consistent with Rosai-Dorfman-Destombes disease. What would you do next?
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Affiliation(s)
- Jasmine H Francis
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Y Pierre Gobin
- Department of Neurosurgery, Weill Cornell Medical Center, New York, New York
| | - Eli L Diamond
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York
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Sassi F, M'rad H, Kacem LB, Sassi B, Hannachi S, Rammeh S. A lesion of the patella: An unexpected location of Rosai-Dorfman disease: A case report. Int J Surg Case Rep 2022; 98:107510. [PMID: 35985119 PMCID: PMC9411659 DOI: 10.1016/j.ijscr.2022.107510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction Primary osseous Rosai-Dorfman disease (RDD) is a rare and benign disease that can pose diagnosis challenges. Presentation of the case We report the case of a 29-year-old woman who presented with pain in her left patellar region for the past 6 months with no other clinical sign especially no lymphadenopathy associated. A surgical excision was done. Histopathology confirmed the diagnosis of a primary RDD patellar disease. The patient was followed up for 2 months without any recurrence. The aim of this study was to present a rare case of RDD in a patellar location and to review clinicopathological features, therapeutic modalities, evolutionary aspects and prognosis of a primary patellar RDD. Discussion and conclusion The diagnosis of a primary osseous RDD without associated lymphadenopathy should be kept in mind when a sclero-lytic lesion is found. Excision of the lesion is the gold standard of the treatment. Isolated patellar RDD is rare. The diagnosis is made on histopathological examination of resected tissue Prognosis is good and disease course is not aggressive
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132
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Li H, Li D, Xia J, Huang H, Jiao N, Zheng Z, Zhao Y, Guo X. Radiological features of Rosai-Dorfman disease: case series and review of the literature. Clin Radiol 2022; 77:e799-e805. [PMID: 36038400 DOI: 10.1016/j.crad.2022.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Abstract
AIM To improve the accuracy of diagnosis of Rosai-Dorfman disease (RDD) by summarising the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics. MATERIALS AND METHODS The clinical manifestations, imaging findings, and pathological characteristics of 14 patients with histopathologically confirmed RDD were analysed retrospectively and a literature review was undertaken. RESULTS Of the 14 patients, nine had multiple lesions and five had single lesions. Eight patients had extranodal lesions, while six had mixed-type lesions. In patients with head and neck lesions, plain CT/MRI revealed irregularly shaped, well-defined, homogeneous, and mainly progressive lesions, with marked homogeneous enhancement on multiphasic contrast-enhanced imaging. One patient had dural lesions, one of which iso-intense to grey matter, with patchy hypo-intensity on T2-weighted imaging, meningeal tail signs, and characteristic crabfoot-like enhancement. Three patients with skeletal system involvement exhibited osteolytic bone destruction without sclerosis at the edges, associated soft-tissue masses, or periosteal reactions. Two patients had well-defined subcutaneous lesions, inhomogeneous density, and progressive parenchymal enhancement on contrast-enhanced CT. One patient had multiple intestinal lesions with inhomogeneous nodular thickening of the blind ascending colon and ileum, with marked and progressive enhancement. CONCLUSION RDD involvement is mainly multifocal, primarily in the head and neck regions. Plain CT/MRI revealed well-defined, irregularly shaped lesions with homogeneous density/signal, with marked and progressive enhancement on multiphasic contrast-enhanced imaging; however, histopathology is still required to confirm the diagnosis of RDD.
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Affiliation(s)
- H Li
- Department of Radiology, Fuyong People's Hospital, Baoan District, Shenzhen 518103, Guangdong, China
| | - D Li
- Department of Radiology, Fuyong People's Hospital, Baoan District, Shenzhen 518103, Guangdong, China
| | - J Xia
- Department of Radiology, First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen 518035, Guangdong, China
| | - H Huang
- Department of Radiology, Fuyong People's Hospital, Baoan District, Shenzhen 518103, Guangdong, China
| | - N Jiao
- Department of Radiology, Shenzhen People's Hospital, Shenzhen 518020, Guangdong, China
| | - Z Zheng
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Y Zhao
- Department of Pathology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China
| | - X Guo
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China.
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133
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Fiani DJ, Émile JF, Istier L, Boutin AB, Tychyj C, Benzerdjeb N, Donzel M, Balme B, Traverse-Glehen A, Fontaine J. Une maladie de Rosai–Dorfman–Destombes de présentation laryngée trompeuse. Ann Pathol 2022; 42:475-480. [DOI: 10.1016/j.annpat.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 10/15/2022]
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134
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Razanamahery J, Abdallahoui M, Chabridon G, Fromont A, Tarris G, Idbaih A, Comby PO, Godard F, Haroche J, Audia S, Bonnotte B. Dramatic Efficacy of Interferon and Vemurafenib on Psychiatric Symptoms Revealing BRAFV600E -Mutated Erdheim-Chester Disease: A Case Report. Front Immunol 2022; 13:918613. [PMID: 35874752 PMCID: PMC9299438 DOI: 10.3389/fimmu.2022.918613] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/08/2022] [Indexed: 12/02/2022] Open
Abstract
Erdheim–Chester disease (ECD) is a rare condition with underestimated neurological involvement. Mild psychiatric symptoms such as mood swings have been rarely described in the clinical spectrum of neuro-ECD. We here describe the first patient with psychiatric manifestations of delirium revealing ECD with neurological involvement with favorable evolution under interferon followed by BRAF inhibitor monotherapy. An 81-year-old woman was referred to the hospital because of delirium and severe cognitive impairment associated with a cerebellar syndrome. Brain magnetic resonance imaging showed “FLAIR-changes” lesions in the pons and upper cerebellum peduncles. Blood and cerebrospinal fluid (CSF) analyses showed normal results except for an elevated neopterin level in the CSF. Whole-body CT scan (18FDG-PET) showed peri-nephric fat infiltration and aorta adventitia sheathing with radiotracer uptake in the pons, vessels, peri-nephric fat, and bone lesions, which was characteristic of ECD. The diagnosis was confirmed on perirenal tissue biopsy, which also showed a BRAFV600E mutation. Treatment with interferon resulted in the resolution of delirium, and treatment with BRAF inhibitor subsequently resulted in a partial remission of all active sites. This case highlights that delirium can be the first manifestation of neurodegenerative ECD. ECD should be screened in unexplained psychiatric features as interferon and targeted therapy appear to be effective in this situation.
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Affiliation(s)
- Jérôme Razanamahery
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - Maroua Abdallahoui
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | | | - Agnès Fromont
- Department of Neurology, Dijon University Hospital, Dijon, France
| | - Georges Tarris
- Department of Pathology, Dijon University Hospital, Dijon, France
| | - Ahmed Idbaih
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Paris, France
| | | | - Francois Godard
- Nuclear Medicine Department, Centre Georges Francois Leclerc, Dijon, France
| | - Julien Haroche
- Department of Internal Medicine 2, National Reference Center for Histiocytosis, Pitié-Salpétrière Hospital, Paris, 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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135
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Popivanov G, Baymakova M, Bochev P, Penchev D, Konaktchieva M, Mutafchiyski V. Localized retroperitoneal Rosai-Dorfman-Destombes disease as a cause of fever of unknown origin in adults. Case report and review of the literature. Int J Surg Case Rep 2022; 97:107414. [PMID: 35872548 PMCID: PMC9403091 DOI: 10.1016/j.ijscr.2022.107414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 02/07/2023] Open
Abstract
The localized abdominal RDD could be a possible cause of FUO. RDD should be considered in the differential diagnosis of localized retroperitoneal mass and FUO. FDG-PET/CT is a useful diagnostic tool for initial diagnosis, staging, and follow-up. In localized RDD, the surgery can be a definitive treatment.
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Affiliation(s)
- Georgi Popivanov
- Department of Surgery, Military Medical Academy, Sofia, Bulgaria,Corresponding author at: Department of Surgery, Military Medical Academy, “Sv. G. Sofiiski” Str. 3, Sofia 1606, Bulgaria.
| | - Magdalena Baymakova
- Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria
| | - Pavel Bochev
- Department of Nuclear Medicine, University Hospital Acibadem City Clinic Cancer Center, Sofia, Bulgaria
| | - Dimitar Penchev
- Department of Surgery, Military Medical Academy, Sofia, Bulgaria
| | - Marina Konaktchieva
- Department of Gastroenterology and Hepatology, Military Medical Academy, Sofia, Bulgaria
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136
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Yang PY, Ma XL, Zhao W, Fu LB, Zhang R, Zeng Q, Qin H, Yu T, Su Y. Malignant histiocytosis associated with mediastinal germ cell tumor: A case report. World J Clin Cases 2022; 10:7116-7123. [PMID: 36051154 PMCID: PMC9297408 DOI: 10.12998/wjcc.v10.i20.7116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/28/2022] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Germ cell tumors (GCTs) account for 2% of human malignancies but are the most common malignant tumors among males aged 15-35. Since 1983, an association between mediastinal GCT (MGCT) and hematologic malignancies has been recognized.
CASE SUMMARY We report a case in which malignant histiocytosis was associated with mediastinal GCTs. The clinical data of a male patient with MGCT admitted to Beijing Children's Hospital were collected retrospectively. The patient was first diagnosed according to imaging and pathological features as having MGCT, and was treated with surgery and chemotherapy. One year after stopping chemotherapy, imaging showed metastases in the right supraclavicular, mediastinum, hilar region and retroperitoneal lymph node, right pleura, right lung, and right para-cardiac margin. Pathological diagnosis of the liver nodular and hilar lymph nodes included systemic juvenile xanthogranuloma and Rosai-Dorfman lesions with malignant transformation (i.e., morphological characteristics and immunophenotype of histiocytic sarcoma). Following diagnosis, the patient accepted chemotherapy with vindesine, cytarabine and dexamethasone. Positron emission tomography–computed tomography showed partial remission. The patient was followed-up for 10 mo after the diagnosis of malignant histiocytosis, and no sign of progression or relapse was observed.
CONCLUSION Physicians should recognize the possibility of hematologic malignancies being associated with MGCT. Suitable sites should be selected for pathological examination.
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Affiliation(s)
- Pei-Yi Yang
- Department of Medical Oncology, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
| | - Xiao-Li Ma
- Department of Medical Oncology, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
| | - Wen Zhao
- Department of Medical Oncology, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
| | - Li-Bing Fu
- Department of Pathology, Beijing Children’s Hospital, Capital Medical University, National Center of Children’s Health, Beijing 100045, China
| | - Rui Zhang
- Hematology Center, Beijing Children’s Hospital, Capital Medical University, National Center of Children’s Health, Beijing 100045, China
| | - Qi Zeng
- Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Hong Qin
- Department of Surgical Oncology, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
| | - Tong Yu
- Department of Image Center, Beijing Children’s Hospital, Capital Medical University, National Center of Children’s Health, Beijing 100045, China
| | - Yan Su
- Department of Medical Oncology, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
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Pattenden TA, Morton A, Keller A. Xanthogranulomatous orchitis: A rare case of testicular mass. Urol Case Rep 2022; 43:102111. [PMID: 35586401 PMCID: PMC9108760 DOI: 10.1016/j.eucr.2022.102111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/01/2022] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
Abstract
Xanthogranulomatous orchitis is a rare non-malignant condition. This study reports a new case of xanthogranulomatous orchitis in a 77-year-old male, who presented with acute right scrotal mass. Ultrasound and computed tomography showed a heterogenous lesion involving the testis, with a loculated collection in the overlying scrotal wall. Scrotal exploration revealed an abscess involving the scrotal skin, with hard mass involving the testis, with histological evidence of infiltration and replacement of most testicular parenchyma. This case highlights this important consideration for xanthogranulomatous orchitis in the differential of testicular mass, particularly when associated with a purulent collection. Section headings Inflammation and Infection General Urology
Xanthogranulomatous orchitis (XGO) is a rare inflammatory condition, limited to 26 case reports within published literature. XGO can be difficult to differentiate from a testicular neoplasm and is usually treated with orchidectomy. This case highlights important inflammatory and infectious differentials for XGO, and how their treatment would differ.
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138
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Rabia R, Al-Taie A, Al-Khafaji F, Barah A. Rosai-Dorfman Disease of the Spine: A Case Report of a Rare Disease and Review of the Literature. Cureus 2022; 14:e26317. [PMID: 35911256 PMCID: PMC9314233 DOI: 10.7759/cureus.26317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/20/2022] Open
Abstract
Rosai-Dorfman disease (also known as sinus histiocytosis with massive lymphadenopathy or Rosai-Dorfman-Destombes disease) is a rare reactive histiocytic disease, classically involving the lymph nodes of the neck, but it can also occur in extranodal sites. Isolated spinal involvement is rare but important to identify as it can mimic malignancy with males being affected more than females. We present a case of a 52-year-old female patient who had breast cancer and was admitted with long-standing anal and sacral pain. The MRI lumbar spine showed a mass concerning for metastasis. CT-guided biopsy results showed sheets of histiocyte-like cells, some of which were positive with S100 and showed emperipolesis along with plasma cells, lymphocytes, and neutrophils. Features were in keeping with Rosai-Dorfman syndrome. The patient responded to steroids. The familiarity with this entity saved the patient from going through the agony of this being considered a metastasis of her primary malignancy.
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139
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Yadav S, Canchi B. Case report of H-syndrome with a review from a rheumatological perspective. BMJ Case Rep 2022; 15:e249414. [PMID: 35732361 PMCID: PMC9226958 DOI: 10.1136/bcr-2022-249414] [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] [Accepted: 06/01/2022] [Indexed: 11/03/2022] Open
Abstract
A woman in her 20s, symptomatic since the age of 4 with short stature, hearing loss, skin hyperpigmentation and induration over the medial aspect of the thigh, hypertrichosis, histiocytes on biopsy, lymphadenopathy, dilated scleral vessels, pancreatic exocrine deficiency, pericardial thickening, swelling of the eyelids and resistant retroperitoneal fibrosis. Whole-genome sequencing showed a mutation in SLC29A3, confirming 'H'-syndrome. She is on steroids and methotrexate. This case highlights the rheumatological mimics of this rare disorder.
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Affiliation(s)
- Sandeep Yadav
- Rheumatology, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Balakrishnan Canchi
- Rheumatology, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
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140
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Liu MM, Wangsiricharoen S, Dhar SI. Novel treatment options for subglottic stenosis in Rosai-Dorfman disease: A case report and review of the literature. OTOLARYNGOLOGY CASE REPORTS 2022. [DOI: 10.1016/j.xocr.2022.100419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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141
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Diagnosis of Rosai-Dorfman Disease by Upper Endoscopic Ultrasound–Guided Fine-Needle Biopsy. ACG Case Rep J 2022; 9:e00789. [DOI: 10.14309/crj.0000000000000789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/02/2022] [Indexed: 11/17/2022] Open
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142
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A Report of Rosai–Dorfman Disease in an Adolescent. Case Rep Pediatr 2022; 2022:9571400. [PMID: 35664545 PMCID: PMC9162837 DOI: 10.1155/2022/9571400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022] Open
Abstract
Rosai–Dorfman disease (RDD) is a rare disease of unknown cause. It is a benign self-limiting condition characterized by the accumulation of activated histiocytes in the sinusoids of lymph nodes and/or extranodal tissues. Massive cervical lymphadenopathy as the initial manifestation tends to raise the initial odds in favour of a lymphoma, and thus reducing the threshold to performing a simple biopsy cannot be overestimated. Herein, we report a 13-year-old adolescent who presented with a progressive posterior left-sided neck swelling. Our diagnosis of RDD was established by demonstrating emperipolesis in histology and S100 positivity in immunohistochemistry as stated in the literature. Although the condition is known to be self-limiting, evidence from the literature and our case management shows that medical therapy can hasten remission in pediatric cases.
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Milman T, Eiger-Moscovich M, Henry RK, Ida CM, Ruben M, Shields CL, Lally SE, Penne RB, Stefanyszyn MA, Bilyk JR, Rapuano CJ, Rabinowitz M, Eagle RC. Cyclin D1 expression and molecular genetic findings in periocular histiocytoses and neoplasms of macrophage-dendritic cell lineage. Am J Ophthalmol 2022; 242:36-51. [PMID: 35594918 DOI: 10.1016/j.ajo.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/06/2022] [Accepted: 05/13/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Frequent activating mutations in the mitogen-activated protein kinase (MAPK) pathway genes have been identified in histiocytoses. MAPK signaling consistently upregulates Cyclin D1. The goal of this study was to determine whether Cyclin D1 expression by immunohistochemistry is a useful diagnostic marker for periocular histiocytoses and to further characterize their genetic basis. DESIGN Retrospective observational case series. METHODS Pathology records were searched for all patients with histiocytoses diagnosed between 1995-2020. Eleven histiocyte-rich inflammatory lesions and 10 xanthelasma served as controls. Cyclin D1 immunohistochemistry was performed on all tissues. A subset of histiocytoses was evaluated by next-generation sequencing (NGS) and droplet digital PCR (ddPCR). RESULTS There were 36 patients, 15 (42%) males and 21 (58%) females, with histiocytoses: 9 (25%) juvenile xanthogranuloma, 8 (22%) adult-onset asthma and periocular xanthogranuloma, 7 (19%) Langerhans cell histiocytosis, 5 (14%) Rosai-Dorfman disease, 5 (14%) xanthogranuloma not otherwise specified, 1 (3%) Erdheim-Chester disease, and 1 (3%) histiocytic sarcoma. Moderate-to-strong nuclear Cyclin D1 expression was present in ≥50% of lesional cells in histiocytoses (23/36, 64%), significantly more when compared to histiocyte-rich inflammatory lesions (0/11, 0%, P<.001) and xanthelasma (0/10, 0%, P<.001). Cyclin D1 was expressed in <10% of lesional cells in all 11 histiocyte-rich inflammatory lesions (P<.001) and all 10 xanthelasma lesions (P<.001). MAPK pathway gene mutations were detected in 12 of 14 (86%) histiocytoses successfully assayed by NGS and/or ddPCR. CONCLUSIONS Our study confirms that the Cyclin D1 immunohistochemical stain is a useful diagnostic marker for periocular histiocytoses, correlating with underlying mutations in MAPK pathway genes.
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Affiliation(s)
- Tatyana Milman
- From the Department of Pathology (T.M., M.E.-M., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Ophthalmology (T.M., C.L.S., S.E.L., R.B.P., M.A.S., J.R.B., C.J.R., M.Ra., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.
| | - Maya Eiger-Moscovich
- From the Department of Pathology (T.M., M.E.-M., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Maya Eiger-Moscovich is currently practicing at Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel. Meghan Ruben is currently practicing at Department of Ophthalmology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Roger K Henry
- Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School at Rutgers University (R.K.H.), Newark, New Jersey
| | - Cristiane M Ida
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Mayo Clinic College of Medicine and Science (C.M.I.), Rochester, Minnesota; USA
| | - Megan Ruben
- Ocular Oncology Service (M.Ru., C.L.S., S.E.L., R.B.P.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Carol L Shields
- Department of Ophthalmology (T.M., C.L.S., S.E.L., R.B.P., M.A.S., J.R.B., C.J.R., M.Ra., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Ocular Oncology Service (M.Ru., C.L.S., S.E.L., R.B.P.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sara E Lally
- Department of Ophthalmology (T.M., C.L.S., S.E.L., R.B.P., M.A.S., J.R.B., C.J.R., M.Ra., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Ocular Oncology Service (M.Ru., C.L.S., S.E.L., R.B.P.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Robert B Penne
- Department of Ophthalmology (T.M., C.L.S., S.E.L., R.B.P., M.A.S., J.R.B., C.J.R., M.Ra., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Ocular Oncology Service (M.Ru., C.L.S., S.E.L., R.B.P.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Mary A Stefanyszyn
- Department of Ophthalmology (T.M., C.L.S., S.E.L., R.B.P., M.A.S., J.R.B., C.J.R., M.Ra., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Oculoplastic and Orbital Surgery (M.A.S., J.R.B., M.Ra.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jurij R Bilyk
- Department of Ophthalmology (T.M., C.L.S., S.E.L., R.B.P., M.A.S., J.R.B., C.J.R., M.Ra., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Oculoplastic and Orbital Surgery (M.A.S., J.R.B., M.Ra.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Christopher J Rapuano
- Department of Ophthalmology (T.M., C.L.S., S.E.L., R.B.P., M.A.S., J.R.B., C.J.R., M.Ra., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Cornea Service (C.J.R.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Michael Rabinowitz
- Department of Ophthalmology (T.M., C.L.S., S.E.L., R.B.P., M.A.S., J.R.B., C.J.R., M.Ra., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Oculoplastic and Orbital Surgery (M.A.S., J.R.B., M.Ra.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ralph C Eagle
- From the Department of Pathology (T.M., M.E.-M., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Ophthalmology (T.M., C.L.S., S.E.L., R.B.P., M.A.S., J.R.B., C.J.R., M.Ra., R.C.E.), Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
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Carroll AS, Doherty CM, Blake J, Hunt SJ, Hoskote C, McNicholl F, Phadke R, Sheehy O, Bremner FD, D'Sa S, McNamara C, Reilly MM. Neurology and the histiocytoses: a case of Rosai-Dorfman-Destombes disease. Pract Neurol 2022; 22:practneurol-2022-003398. [PMID: 35534197 DOI: 10.1136/practneurol-2022-003398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2022] [Indexed: 11/04/2022]
Abstract
The histiocytoses are a group of rare disorders characterised by the accumulation of neoplastic or non-neoplastic activated histiocytes in various tissues. Phenotypes vary widely from cutaneous lesions or lymphadenopathy that regress spontaneously to disseminated disease with poor prognosis. Neurological symptoms can be a presenting feature or appear during the course of disease. We present a challenging diagnostic and management case of Rosai-Dorfman-Destombes disease in a 48-year-old woman with a relapsing, partially steroid-responsive syndrome comprising patchy, non-length-dependent radiculoneuropathy with diffuse pachymeningitis and widespread systemic disease, and recent dramatic response to novel mitogen-activated kinase pathway inhibition. We discuss the clinical characteristics, diagnosis, recent breakthroughs in pathogenesis and emerging treatment options for Rosai-Dorfman disease and for the histiocytoses with neurological sequelae, including Langerhans cell histiocytosis and Erdheim-Chester disease.
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Affiliation(s)
- Antonia S Carroll
- Brain and Mind Centre, Faculty of Medicine and Health, Translational Research Collective, The University of Sydney, Sydney, New South Wales, Australia
- MRC Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - Carolynne M Doherty
- MRC Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - Julian Blake
- Neurophysiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Clinical Neurophysiology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Stephen J Hunt
- Neurology, Belfast Health and Social Care Trust, Belfast, UK
| | - Chandrashekar Hoskote
- Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Rahul Phadke
- Neuropathology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Oonagh Sheehy
- Haematology, Belfast Health and Social Care Trust, Belfast, UK
| | - Fion D Bremner
- Neuro-ophthalmology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Shirley D'Sa
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Christopher McNamara
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Mary M Reilly
- MRC Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Institute of Neurology, London, UK
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145
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Zhao EJ, Gauiran DTV, Slack GW, Dutz JP, Chen LYC. A 54-Year-Old Woman with Cutaneous Nodules. NEJM EVIDENCE 2022; 1:EVIDmr2200035. [PMID: 38319205 DOI: 10.1056/evidmr2200035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
A 54-Year-Old Woman with Cutaneous NodulesA 54-year-old woman presented with chronic cutaneous nodules and plaques. How do you approach the evaluation, and what is the diagnosis?
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Affiliation(s)
- Eric J Zhao
- The University of British Columbia Hematology Fellowship Program
| | | | - Graham W Slack
- The University of British Columbia Hematology Fellowship Program
| | - Jan P Dutz
- The University of British Columbia Hematology Fellowship Program
| | - Luke Y C Chen
- The University of British Columbia Hematology Fellowship Program
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146
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Management of central nervous system Rosai-Dorfman disease: A single center treatment experience. J Clin Neurosci 2022; 99:275-281. [DOI: 10.1016/j.jocn.2022.03.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/19/2021] [Accepted: 03/16/2022] [Indexed: 02/06/2023]
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147
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Gazia C, Giordano L, Diodoro MG, Compalati I, Avantifiori R, Grazi GL. Differential diagnosis in Rosai-Dorfman disease: A rare case of isolated hepatic presentation mimicking a metastatic tumor with positive 18-FDG uptake. Intractable Rare Dis Res 2022; 11:90-92. [PMID: 35702580 PMCID: PMC9161131 DOI: 10.5582/irdr.2022.01037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 11/05/2022] Open
Abstract
Rosai-Dorfman disease (RDD) is also called sinus histiocytosis with massive lymphadenopathy, and it is caused by a histiocytic disorder with unclear etiology. It usually involves cervical lymph nodes, but it may also present with extranodal involvement. We report a rare condition of isolated hepatic RDD without nodal involvement, clinically manifested with three-month abdominal pain and tenderness of the right hypochondrium. CT- and PET-CT scans were compatible with a secondary lesion from an unknown primary tumor. Therefore, the patient underwent an atypical liver resection. Immunohistochemistry and histological results were compatible with a diagnosis of RDD. RDD is characterized by phenomena of emperipolesis, histiocytic proliferation and positive immunostaining for CD14, CD68 and S-100 protein. Cases of isolated gastrointestinal localization of RDD are particularly rare, especially in the liver. Instrumental exams might confuse RDD with other malignancies. RDD is a rare entity, which might be misdiagnosed using PET-CT due to its similarities with malignant tumors. An accurate multidisciplinary approach may help to clear diagnostic clues of this uncommon disease.
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Affiliation(s)
- Carlo Gazia
- Hepatopancreatobiliary Surgery, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
- Address correspondence to:Carlo Gazia, Hepatopancreatobiliary Surgery, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy. E-mail: ; ;
| | - Luca Giordano
- Hepatopancreatobiliary Surgery, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
- Faculty of Pharmacy and Medicine, Department of Surgery, University of Rome "La Sapienza", Rome, Italy
| | - Maria Grazia Diodoro
- Department of Pathology, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
| | - Iacopo Compalati
- Hepatopancreatobiliary Surgery, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
- Faculty of Medicine and Psychology, Surgical and Medical Department of Translational Medicine, University of Rome "La Sapienza", Sant'Andrea Hospital of Rome, Rome, Italy
| | - Riccardo Avantifiori
- Hepatopancreatobiliary Surgery, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
- Faculty of Pharmacy and Medicine, Department of Surgery, University of Rome "La Sapienza", Rome, Italy
| | - Gian Luca Grazi
- Hepatopancreatobiliary Surgery, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
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Choi R, Ring N, McNiff JM, Wilson LD, Martin K, Leventhal J. Treatment of multifocal cutaneous Rosai-Dorfman disease with radiotherapy. JAAD Case Rep 2022; 23:106-108. [PMID: 35495976 PMCID: PMC9039858 DOI: 10.1016/j.jdcr.2022.03.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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149
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Greggianin C, Yasufuku K, Tong LC, Dhillon G, Digby GC. Middle Mediastinal Mass Compressing the Pulmonary Trunk in a Patient With a History of Breast Cancer. Chest 2022; 161:e265-e272. [DOI: 10.1016/j.chest.2021.12.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/13/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022] Open
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150
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Yazbeck M, Comair Y, Berjaoui C, Dabboucy B. Craniocervical Rosai-Dorfman Disease presentation: Case report and review of literature. Neurocirugia (Astur) 2022. [DOI: 10.1016/j.neucir.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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