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Basu S, Gala R, Gohil K. Spinal Rosai-Dorfman disease-a report of 2 cases and review of literature. Spinal Cord Ser Cases 2023; 9:36. [PMID: 37516782 PMCID: PMC10387076 DOI: 10.1038/s41394-023-00600-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/12/2023] [Accepted: 07/24/2023] [Indexed: 07/31/2023] Open
Abstract
INTRODUCTION Rosai-Dorfman Disease (RDD) is a rare benign histiocytic disease that infrequently affects the spine. We report two cases of spinal RDD and review the relevant literature. This report addresses the various diagnostic dilemmas related to the evaluation of Spinal RDD and its treatment. CASE PRESENTATION Case 1: A 32-year-old male presented with low back pain and left anterior thigh for last 8 months. On examination, there was sensory diminution on inner aspects of the thigh with an absent left knee jerk. CT/MRI scans revealed an extradural lesion at L2/3 with neural compression. PET scan showed several hypermetabolic lesions in ribs, humerus, femur, and vertebrae. He underwent en bloc excision of the extradural mass with L2-3 pedicle screw-rod fixation and was later managed with chemotherapy. Case 2: A 42-year-old male presented with spastic paraparesis with urinary incontinence for the last 4 weeks. On examination, he had a neurological level of T6. MRI scan revealed a lesion in posterior elements of T6-7 compressing the spinal cord. He underwent T6-7 laminectomy with decompression. In both cases, the diagnosis was confirmed by histopathology and further managed by Hemato-oncologist. They both did well at 1-year follow-up with improvement in neurology. DISCUSSION Spinal RDD to date remains a large diagnostic dilemma with no pathognomonic clinical or radiological features; mimicking many osteolytic lesions in the spine. The diagnosis is purely histopathological and immunological. The lesion's complete surgical excision is the mainstay of treatment with a better prognosis and decreased chances of recurrences.
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Affiliation(s)
- Saumyajit Basu
- Head of Department of Spine Surgery, Kothari Medical Centre, Kolkata, India
| | - Rohan Gala
- Department of Orthopedics, DY Patil University School of Medicine, Hospital and Research Centre, Nerul Navi Mumbai, India
| | - Kushal Gohil
- Department of Orthopedics, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, India.
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Cao X, Yao B, Ma J, Li D, Wang L, Zhang J, Wu Z. Rosai-Dorfman Disease in the Skull Base: A Case Series Study. World Neurosurg 2023; 173:e351-e358. [PMID: 36796628 DOI: 10.1016/j.wneu.2023.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE Rosai-Dorfman disease (RDD) is a rare, idiopathic, and non-neoplastic histio-proliferative disease that is uncommon in the central nervous system. Hence, reports of management of RDD in the skull base are scarce and only a few studies on skull base RDD are available. The objective of this study was to analyze the diagnosis, treatment, and prognosis of RDD in the skull base and explore an appropriate treatment strategy thereof. METHODS Nine patients with clinical characteristics and follow-up data from our department between 2017 and 2022 were included in this study. From this information, the clinical profiles, imaging, treatment, and prognosis data were collected. RESULTS There were 6 male and 3 female patients with skull base RDD. These patients ranged in age from 13 to 61 years, with a median age of 41 years. The locations included 1 anterior skull base orbital apex, 1 parasellar region, 2 sellar regions, 1 petroclivus, and 4 foramen magnum regions. Six patients underwent total resection and 3 underwent subtotal resection. Patient follow-up lasted 11-65 months, with a median duration of 24 months. One patient died, 2 experienced recurrence, and the other patients' lesions were stable. The symptoms worsened and new complications occurred in 5 patients. CONCLUSIONS Skull base RDDs are intractable diseases with a high rate of complications. Some patients are at risk of recurrence and death. Surgery may be the basic treatment for this disease, and combined therapy including targeted therapy or radiation therapy may also be a valuable therapeutic strategy.
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Affiliation(s)
- Xiaoyu Cao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Bohan Yao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Junpeng Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Da Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Liang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
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Muacevic A, Adler JR, Bhansali PJ, Shetty ND, Shelar SS, Suryadevara M, Dharmadhikari A. Intracranial Rosai-Dorfman Disease: A Case to Remember. Cureus 2022; 14:e32605. [PMID: 36660540 PMCID: PMC9845528 DOI: 10.7759/cureus.32605] [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: 10/14/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
Sinus histiocytosis with massive lymphadenopathy (SHML), an alternative term for Rosai-Dorfman disease (RDD), is a rare benign idiopathic immune-related lymphoproliferative condition. The central nervous system (CNS) has been documented to be involved in RDD, although lymph nodes are the organs that are most frequently and primarily associated with the disease manifestation. Nonetheless, CNS involvement in RDD is rare and poorly understood. As a result, there is a lack of a solid basis for therapeutic approaches for CNS involvement in RDD. Here, we present a case of RDD with cerebral involvement, a rare presentation of RDD with atypical symptoms. A brief assessment of the radiographic appearance, histological findings, and the peculiar manifestations of the disease is provided.
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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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Tatit RT, Raffa PEAZ, de Almeida Motta GC, Bocchi AA, Guimaraes JL, Franceschini PR, de Aguiar PHP. Rosai-Dorfman disease mimicking images of meningiomas: Two case reports and literature review. Surg Neurol Int 2021; 12:292. [PMID: 34221623 PMCID: PMC8247728 DOI: 10.25259/sni_918_2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/11/2021] [Indexed: 11/05/2022] Open
Abstract
Background: Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytic proliferative disorder classically as a massive cervical lymphadenopathy. However, over the years, extranodal locations were confirmed with the central nervous system involvement in less than 5% of cases, which is marked as a significant differential diagnosis of meningiomas, with which they are widely confused due to the similarity of their radiological images. Case Description: We report a 37-year-old man and 45-year-old man who were diagnosed with intracranial RDD but whose radiological images mimic meningiomas, requiring anatomopathological and tumor’s immunohistochemistry for definitive diagnosis. Moreover, a review of 184 publications with 285 cases of intracranial involvement of this disease was also performed, comparing these findings with those brought in the previous studies. Conclusion: Intracranial Rosai-Dorfman tumors should always be remembered as differential diagnosis of meningiomas since they are similar radiologically and macroscopically. Once remembered and diagnosed, the lesion must be treated following the same pattern of resection done in meningiomas and, treatment’s differences will not occur in the surgical excision technique, but in complementary chemotherapy implementation, radiotherapy, and even with radiosurgery aid, depending on the case. Thus, it is possible to obtain better results than with just the isolated surgical procedure.
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Affiliation(s)
- Rafael Trindade Tatit
- Department of Medicine, Albert Einstein Israeli Faculty of Health Sciences, São Paulo, Brazil
| | | | | | | | - Júlia Loripe Guimaraes
- Department of Medicine, Albert Einstein Israeli Faculty of Health Sciences, São Paulo, Brazil
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Safi SS, Murshed K, Ali A, Vattoth S, Haider A, Al-Bozom I. Rosai-Dorfman disease of cranial and spinal origin - A case series. Surg Neurol Int 2020; 11:298. [PMID: 33093975 PMCID: PMC7568110 DOI: 10.25259/sni_391_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/28/2020] [Indexed: 11/04/2022] Open
Abstract
Background Rosai-Dorfman disease (RDD) is an idiopathic nonneoplastic lymphadenopathy disorder which is characterized by lymph node enlargement, but it may also presents primarily involving a variety of extranodal sites, including central nerves system and craniospinal axis. This study reports five cases of craniospinal RDD, with review of epidemiology, clinical presentation, imaging, and histopathological features with current management strategies. Case Description Five cases of RDD are diagnosed at Hamad General Hospital, Qatar, during 2013-2018. Two cases had dural-based cranial lesions with overlying cranial involvement while three cases were having extradural thoracic spine lesions. All cases underwent surgical intervention and confirmed by histopathology. Conclusion Craniospinal RDD is a rare clinical presentation and poses significant diagnostic challenges preoperatively due to its similarity with other neoplastic or inflammatory diseases. Surgical option to remove compressive neural pathology provides a good clinical outcome with no recurrence in long-term follow-up.
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Affiliation(s)
| | - Khaled Murshed
- Department of Histopathology, Hamad General Hospital, Doha, Qatar
| | - Arshad Ali
- Department of Neurosurgery, Hamad General Hospital, Doha, Qatar
| | - Surjith Vattoth
- Department of Neuroradiology, Hamad General Hospital, Doha, Qatar
| | | | - Issam Al-Bozom
- Department of Histopathology, Hamad General Hospital, Doha, Qatar
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Wang C, Kuang P, Xu F, Hu L. Intracranial Rosai-Dorfman disease with the petroclival and parasellar involvement mimicking multiple meningiomas: A case report and review of literature. Medicine (Baltimore) 2019; 98:e15548. [PMID: 31045846 PMCID: PMC6504270 DOI: 10.1097/md.0000000000015548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytosis. Petroclival RDD is extremely rare. To the best of our knowledge, only 7 cases of petroclival RDD have been reported so far. Herein, we present the 8th case of intracranial RDD with the petroclival and parasellar involvement mimicking multiple meningiomas. PATIENT CONCERNS A 57-year-old woman presented with a 1-year history of vision diminution and 1-month hearing loss in her right ear. DIAGNOSES Contrast-enhanced Magnetic resonance imaging (MRI) of the brain demonstrated multiple well-defined, homogenous mass which closely related to the dura mater in the bilateral parasellar and petroclival regions range from the basement of anterior to posterior cranial fossa. The lesions were T1 isointense, T2 hypointense, and homogeneously enhanced. Initial diagnosis of multiple meningiomas was made according to MRI findings. Final diagnosis of RDD was confirmed by histopathological and immunohistochemical examinations after subtotal surgical resection. INTERVENTIONS The patient received subtotal resection because multiple lesions were extensive. OUTCOMES The vision diminution recovered well after the surgery but the hearing loss in her right ear was still persisted. LESSONS Although rare, a standard RDD typically are dural-based, extra-axial, well-circumscribed masses mimicking meningioma, and presenting with characterized hypo to isointense on T1-weighted images, hypo to isointense on T2-weighted images, and obvious enhancement. Resection of the intracranial lesion is the most effective treatment. In case of subtotal resection, the application of adjunctive radiotherapy and/or steroid agents should be advised. Final diagnosis of RDD should be confirmed by histopathological and immunohistochemical examinations.
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Affiliation(s)
- Chao Wang
- Department of Radiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University
| | - Pingding Kuang
- Department of Radiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University
| | - Fangfang Xu
- Department of Radiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University
| | - Ling Hu
- Department of Ultrasound, Hangzhou Women's Hospital, Hangzhou, Zhejiang, China
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Xu Q, Fu L, Liu C. Multimodality imaging-based evaluation of Rosai-Dorfman disease in the head and neck: A retrospective observational study. Medicine (Baltimore) 2017; 96:e9372. [PMID: 29390533 PMCID: PMC5758235 DOI: 10.1097/md.0000000000009372] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Rosai-Dorfman disease (RDD) is an uncommon benign entity characterized histologically by lymphatic sinus dilatation due to histiocyte proliferation. This study was performed to delineate its imaging features, reviewed retrospectively in 12 patients (8 women and 4 men, mean age 58.2 years [range 27-84]) with pathologically confirmed RDD in the head and neck. The location, involvement, and imaging characteristics (CT, magnetic resonance imaging (MRI), and PET/CT) of all lesions were evaluated. Signal intensity on MRI images was compared to gray matter (orbital RDD) and adjacent muscle (sinonasal and cervical RDD). RDD in the head and neck involved multiple sites, primarily the sinonasal cavity (n = 7), neck (n = 3), and orbit (n = 1), with one case of simultaneous involvement of the sinonasal cavity, orbit, and neck. With sinonasal involvement, MRI signal intensity of the involved areas was isointense or slightly hyperintense relative to adjacent muscle on T1WI images and heterogeneous on T2WI images; with lacrimal involvement, it was isointense relative to gray matter on T1- and T2-weighted images; and with neck involvement, it was isointense relative to muscle on T1WI images and relatively hyperintense on T2WI images, with homogenous postcontrast enhancement in all sites of involvement. The lesions on CT were observed as enhancing masses with or without bony destruction. PET/CT showed hypermetabolism in one lesion in the neck. RDD is a rare disorder with multiple sites of involvement in the head and neck. Concomitant cervical lymphadenopathy with extranodal masses assisted by multimodal imaging may be useful in the diagnosis of RDD.
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Affiliation(s)
- Qinggang Xu
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University
| | - Liping Fu
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army and Military Medical Postgraduate College
| | - Chengyao Liu
- Department of Otorhinolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Tan S, Ruan L, Jin K, Wang F, Mou J, Huang H, Yang G. Systemic Rosai-Dorfman disease with central nervous system involvement. Int J Neurosci 2017; 128:192-197. [PMID: 28881164 DOI: 10.1080/00207454.2017.1377709] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Rosai-Dorfman disease (RDD) is a rare idiopathic and lymphoproliferative disorder. Central nervous system (CNS) involvement is infrequent and typically manifests as an isolated lesion. In this article, we describe an unusual case of RDD with multiple lesions in the CNS, upper respiratory tract and lymph nodes. A literature review revealed 45 cases (including the one described herein) of systemic RDD with CNS involvement documented to date. Among these cases, 29 (64.4%) presented with intracranial lesions, 10 (22.2%) with spinal lesions and 6 (13.3%) with both. While the condition of most patients was stable, only four died from RDD or for other reasons. Prognosis is good for most patients, even those with extensive lesions. Although there are various treatments for RDD, surgery is preferred. Given the rarity of RDD, multicenter international collaborations are advocated in order to study disease pathogenesis and develop effective treatment strategies.
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Affiliation(s)
- Song Tan
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Lunliang Ruan
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Kai Jin
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Fuchao Wang
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Jiamin Mou
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Hua Huang
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Gang Yang
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
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Joshi SS, Joshi S, Muzumdar G, Turel KE, Shah RM, Ammbulkar I, Hussain MM, Choudhari KA. Cranio-spinal Rosai Dorfman disease: case series and literature review. Br J Neurosurg 2017; 33:176-183. [PMID: 28532172 DOI: 10.1080/02688697.2017.1329517] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Rosai-Dorfman disease (RDD) is a rare condition similar to lymphomas, presenting with cervical lymphadenopathy in young adults. Extra-nodal involvement is relatively common but involvement of the central nervous system (CNS) is rare. Cranial RDD presents with symptoms of raised intracranial pressure, focal or generalised seizures, while spinal RDD presents with pain, peripheral neurological deficits and radiculopathy. In contrast to other similar neoplastic or degenerative conditions affecting the CNS, RDD is a benign, non-infective, granulomatous disorder. Radiologically cranio-spinal RDD often mimics commoner dural-based lesions like meningioma, with only subtle radiological differentiating findings on Magnetic Resonance Imaging (MRI). The histopathology of RDD is diagnostic. Surgical excision is preferred modality of treatment. However, adjuvant therapies like steroids and radiation may help controlling residual or recurrent disease. There are multiple sporadic reports and short case publications in the literature, often focusing on a particular aspect of RDD. In this study, authors aim to present five cases of craniospinal RDD, and comprehensive review of literature and highlight neurological complications of systemic RDD.
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Affiliation(s)
- Shashank S Joshi
- a Department of Neurosurgery , Hindu Rhiday Samrat Balasaheb Thakare Medical College & Dr R N Cooper Hospital , Mumbai , Maharashtra , India.,b Department of Neurosurgery , Sevenhills Hospital , Mumbai , Maharashtra , India
| | - Shilpa Joshi
- c Department of CT and MRI , Fortis Hospitals , Mumbai , Maharashtra , India
| | - Girish Muzumdar
- d Department of Histopathology , Bombay Hospital Institute of Medical Sciences , Mumbai , Maharashtra , India
| | - Keki E Turel
- e Department of Neurosurgery , Bombay Hospital Institute of Medical Sciences , Mumbai , Maharashtra , India
| | - Rajan M Shah
- b Department of Neurosurgery , Sevenhills Hospital , Mumbai , Maharashtra , India.,e Department of Neurosurgery , Bombay Hospital Institute of Medical Sciences , Mumbai , Maharashtra , India
| | - Indoo Ammbulkar
- f Department of Medical Oncology , Sevenhills Hospital , Mumbai , Maharashtra , India
| | | | - Kishor A Choudhari
- h Department of Neurosurgery , Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust , Sheffield , UK
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Xu H, Zhang F, Lu F, Jiang J. Spinal Rosai-Dorfman disease: case report and literature review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 26:117-127. [PMID: 28168342 DOI: 10.1007/s00586-017-4975-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 12/01/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Sinus histiocytosis with massive lymphadenopathy or Rosai-Dorfman disease (RDD) is a rare benign disease of dubious etiology that arises predominantly in lymph nodes with generalized fever and malaise. Isolated intraspinal involvement has its unique characteristics. The purpose of this study is to present the largest series of cases in the spinal Rosai-Dorfman disease literature to increase familiarity with its clinicopathologic features, diagnosis, and treatment of RDD from spine. METHODS We present the case of a 34-year-old man who presented with paraplegia secondary to an isolated thoracic vertebral lesion. On physical exam, the patient displayed progressive weakness and tendon hyperreflexia of the lower limbs. After a totally section, symptoms of the patient were obviously relieved and the patient remained asymptomatic and no signs of recurrences were observed after follow-up for 5 months. We also retrospectively analyzed 60 cases of patients with spinal RDD published in English since 1969. Clinical date, histopathology, and radiological feature were retrospectively analyzed. RESULTS Spinal RDD should no longer be considered rare and it may occupy an increasingly prominent place in the list of differential diagnoses for intraspinal lesions. Only elaborate histopathology was diagnostic for RDD. Most of the patients were surgically treated and marked improvements were observed in their clinical conditions. CONCLUSIONS RDD with spinal involvement is uncommon and it is challengeable in making a certain diagnosis. Histopathologic characteristics and immunohistochemical findings are considered as the key points for the diagnosis of this disease. The optimal treatment remains controversial, and more efforts should be focused on the investigation of etiology and adjuvant therapy for relapsing cases or subresected lesions.
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Affiliation(s)
- Haocheng Xu
- Department of Orthopedics, Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, China
| | - Fan Zhang
- Department of Orthopedics, Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, China
| | - Feizhou Lu
- Department of Orthopedics, Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, China. .,The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
| | - Jianyuan Jiang
- Department of Orthopedics, Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, China
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Luo Z, Zhang Y, Zhao P, Lu H, Yang K, Zhang Y, Zeng Y. Characteristics of Rosai-Dorfman Disease Primarily Involved in the Central Nervous System: 3 Case Reports and Review of Literature. World Neurosurg 2017; 97:58-63. [DOI: 10.1016/j.wneu.2016.09.084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 09/16/2016] [Accepted: 09/20/2016] [Indexed: 10/20/2022]
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di Dio F, Mariotti I, Coccolini E, Bruzzi P, Predieri B, Iughetti L. Unusual presentation of Rosai-Dorfman disease in a 14-month-old Italian child: a case report and review of the literature. BMC Pediatr 2016; 16:62. [PMID: 27142277 PMCID: PMC4855344 DOI: 10.1186/s12887-016-0595-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 04/21/2016] [Indexed: 01/16/2023] Open
Abstract
Background Rosai-Dorfman disease (RDD) is a rare form of histiocytosis characterized by histiocyte proliferation within lymph nodes and extranodal tissue. Here we report an unusual presentation of RDD in an Italian toddler. Moreover, we reviewed the pediatric case reports published between 2004 and 2014, focusing in particular on medical therapy. Case presentation We report the case of a 14-month-old child who developed a progressive swelling of the right parotid, associated with systemic symptoms and abnormal blood tests. During diagnostic work-up, cervical, intraparotid, and unilateral hilar lymphadenopathies were found. Histopathological and immunohistochemistry studies of a cervical lymph node biopsy established the diagnosis of RDD, with positive PCR for Epstein - Barr virus on the biopsy specimen. Oral steroid therapy was started with progressive reduction in size of all lesions, resolution of systemic symptoms, and normalization of blood tests. Conclusion RDD is generally considered a benign and self-limiting form of histiocytosis, usually associated with favorable prognosis. However, complications are not infrequent and fatal cases were reported even in children. Efforts should be made to establish the best therapeutic strategy for this disease, as no well-defined guidelines exist. Finally, RDD should be included in differential diagnosis of lymphadenopathy and parotid swelling even in very young children. Electronic supplementary material The online version of this article (doi:10.1186/s12887-016-0595-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Francesco di Dio
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Ilaria Mariotti
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Elena Coccolini
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Patrizia Bruzzi
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Barbara Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy.
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Kozak B, Talbott J, Uzelac A, Rehani B. Rosai-Dorfman Disease Isolated to the Thoracic Epidural Spine. J Radiol Case Rep 2015; 9:6-16. [PMID: 27252790 DOI: 10.3941/jrcr.v9i11.2629] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Rosai-Dorfman disease is a rare benign histiocytic disease that infrequently presents in the spine. We report a case of Rosai-Dorfman disease isolated to the epidural thoracic spine in a 26-year-old male. To our knowledge, this is the 15th reported case of isolated spinal disease and only the fourth case of isolated thoracic epidural disease. Given its rarity as well as non-specific symptoms and imaging findings, Rosai-Dorfman disease is often not considered and misdiagnosed on imaging studies. To help improve awareness of Rosai-Dorfman spinal disease, we review the literature and discuss the epidemiology, clinical presentation, imaging features, and treatment considerations for this condition.
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Affiliation(s)
- Benjamin Kozak
- School of Medicine, University of California, San Francisco, CA, USA
| | - Jason Talbott
- Department of Radiology and Biomedical Imaging, San Francisco General Hospital, San Francisco CA, USA; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Alina Uzelac
- Department of Radiology and Biomedical Imaging, San Francisco General Hospital, San Francisco CA, USA
| | - Bhavya Rehani
- Department of Radiology and Biomedical Imaging, San Francisco General Hospital, San Francisco CA, USA; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
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Rosai-Dorfman disease involving the central nervous system: seven cases from one institute. Acta Neurochir (Wien) 2015. [PMID: 26210482 DOI: 10.1007/s00701-015-2511-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Rosai-Dorfman disease (RDD) is a rare, idiopathic, non-neoplastic histioproliferative disease. Central nervous system (CNS) manifestations are extremely rare. Its low incidence and unknown etiology restrict early diagnosis and optimal therapy. METHODS In the 1995-2013 period, seven CNS-RDD patients with intracranial and/or spinal lesions were retrospectively analyzed, including the clinical data, laboratory and imaging results, treatment applied and outcome. All seven case samples were screened for the SLC29A3 gene mutation, and the literature was reviewed. RESULTS Seven RDD patients (6 male/1 female, aged between 7 and 68) with CNS manifestations are reported. Five of the seven patients (71.4 %) had intracranial lesions (1 with skull erosion and 1 with multiple lesions mimicking meningiomas), and two (28.6 %) had spinal subdural lesions. The patients' symptoms included headaches, seizures, visual loss, epileptoid convulsions in the lower legs, fever, spastic paraparesis and paraplegia. An elevated erythrocyte sedimentation rate (ESR) was detected in five of the seven cases. The diagnosis was confirmed by immunohistochemical staining revealing that the characteristic histiocytes were positive for the S100 protein and CD68 and negative for CD1a. All patients were operated on: three recovered completely, two were partially rehabilitated, and two died. No SLC29A3 gene mutations were found in any of the seven samples. CONCLUSION This short series suggests the following: (1) RDD should be included in the differential diagnosis of lesions mimicking intracranial/spinal meningiomas or inflammatory lesions, especially in children; (2) the definitive diagnosis is based on histopathology and immunocytochemistry; (3) surgical resection seems to be the most effective therapy; (4) the exact etiology and adjuvant therapy for relapsing/incompletely resected lesions remain to be established.
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Tian Y, Wang J, Ge JZ, Ma Z, Ge M. Intracranial Rosai-Dorfman disease mimicking multiple meningiomas in a child: a case report and review of the literature. Childs Nerv Syst 2015; 31:317-23. [PMID: 25183389 DOI: 10.1007/s00381-014-2536-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 08/18/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Rosai-Dorfman disease (RDD) is a rare idiopathic, non-neoplastic histioproliferative disease. Central nervous system (CNS) manifestations are extremely rare. In this paper, we describe a 6-year-old boy with intracranial RDD mimicking multiple meningiomas both clinically and radiologically. We reviewed the literature to understand the clinical behaviour, clinicopathological features and treatment options. METHODS A PubMed (US National Library of Medicine) search using the keywords 'Rosai-Dorfman disease' and 'central nervous system' was performed and citations were reviewed. RESULTS Eighty-five cases of RDD involving the CNS have been reported until date, and only 7 cases involved children. Of the 85 cases, 16 cases mimicked multiple meningiomas. Our case is the first to involve multiple lesions in a child under 14 years old. CONCLUSION After reviewing the literature, we concluded that RDD should be considered as a differential diagnosis for lesions mimicking multiple meningiomas, especially in children. Resection of the intracranial lesion is the most effective treatment, and a definitive diagnosis should be based on histopathologic and immunocytochemical examinations.
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Affiliation(s)
- Yongji Tian
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
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Sciacca S, Barkas K, Heptinstall L, McNamara C, Shetty R. Rosai-Dorfman disease with spinal cord compression: a diagnostic challenge. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 24 Suppl 4:S529-35. [PMID: 25398443 DOI: 10.1007/s00586-014-3671-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 11/03/2014] [Accepted: 11/03/2014] [Indexed: 12/31/2022]
Abstract
PURPOSE Rosai-Dorfman disease (RDD) is an uncommon benign histiocytic proliferative disorder commonly involving the cervical lymph nodes and less frequently extranodal sites, including, rarely, the central nervous system, mainly intracranially. Spinal involvement is unusual. RDD is characterized by pathognomonic histopathological features, which are decisive in the definitive diagnosis. We present the case of a 75-year-old lady who presented with an isolated thoracic vertebral lesion. She underwent 3 CT-guided biopsies, all not confirmative for a definite diagnosis, and 2 open biopsies and debulking of the lesion. METHODS The clinical notes, operation notes, investigations and clinic letters of the patient were reviewed. A literature search was performed using PubMed, with the keywords "Rosai-Dorfman disease", "sinus histiocytosis with massive lymphadenopathy", "histiocytic proliferative disorder". RESULTS Only the histopathology after the last procedure was diagnostic for Rosai-Dorfman disease. The patient was treated with steroids with marked improvement in her clinical condition. CONCLUSIONS This case demonstrates the challenge in making a diagnosis. RDD should be considered as a differential diagnosis in case of spinal lesion and non-diagnostic biopsy, especially in steroid sensitive lesions. The implications of the case are discussed.
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Affiliation(s)
- Sara Sciacca
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK,
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Sandoval-Sus JD, Sandoval-Leon AC, Chapman JR, Velazquez-Vega J, Borja MJ, Rosenberg S, Lossos A, Lossos IS. Rosai-Dorfman disease of the central nervous system: report of 6 cases and review of the literature. Medicine (Baltimore) 2014; 93:165-175. [PMID: 24797172 PMCID: PMC4632912 DOI: 10.1097/md.0000000000000030] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy (SHML), is an uncommon benign idiopathic lymphoproliferative disorder. The histologic hallmark of RDD is the finding of emperipolesis displayed by lesional histiocytes. While RDD most commonly affects lymph nodes, extranodal involvement of multiple organs has been reported, including the central nervous system (CNS). However, CNS involvement in RDD is rare and is not well characterized. As a result, therapeutic approaches to CNS involvement in RDD are not well established. Herein we report 6 cases of RDD with isolated CNS involvement and review the literature on RDD with CNS involvement. One of the presented cases exhibited intramedullary involvement of the spinal cord--a very rare form of RDD with CNS involvement.
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Affiliation(s)
- Jose D Sandoval-Sus
- From the Department of Medicine (JDS-S, ACS-L, ISL), Department of Pathology (JRC, JV-V), and Department of Radiology (MJB), University of Miami, Miami, Florida, Division of Hematology-Oncology (ISL), Department of Medicine, and Department of Molecular and Cellular Pharmacology (ISL), University of Miami, Sylvester Comprehensive Cancer Center, Miami, Florida, and Department of Neurology (SR, AL), Hebrew University-Hadassah Medical Center, Jerusalem, Israel
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Abstract
BACKGROUND Rosai-Dorfman disease (RDD) is a rare, idiopathic, histiocytic proliferative disorder, the infrequent occurrence of which limits in-depth studies. Consequently, many characteristics of this disease remain unknown, restricting early diagnosis and proper treatment. METHODS In this study, the literature was reviewed and a retrospective analysis of the medical records of 13 patients with RDD conducted to investigate the demographic data, clinical data, laboratory and imaging results, treatment, and prognosis of this disease. RESULTS Of the 13 cases in our sample, 10 (77%) were purely extranodal RDD, 2 (15%) were both nodal and extranodal, and 1 (8%) was purely nodal. The locations of the 10 purely extranodal RDD lesions included the central nervous system (n = 6, 60%), nasal cavity and paranasal sinuses (n = 3, 30%), and the cutis (n = 1, 10%). The locations of the central nervous system-related RDD lesions included the cerebral subdura (n = 2, 29%), the sellar region (n = 3, 14%), the cerebral parenchyma (n = 1, 14%) and the spinal subdura (n = 1, 14%). Ten patients (77%) had stable conditions, 3 (23%) experienced recurrence, and 2 (15%) experienced recurrence and lesion metastasis. CONCLUSIONS RDD is rare, requiring knowledge of its clinical manifestations for a rapid and correct diagnosis. In light of the possibility of recurrence and lesion metastasis, long-term follow-up is needed. Treatment is still controversial. Future efforts should be directed at investigating the etiology and postoperative treatment for relapsing cases or those with subresected lesions.
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Tomio R, Katayama M, Takenaka N, Imanishi T. Complications of surgical treatment of Rosai-Dorfman disease: A case report and review. Surg Neurol Int 2012; 3:1. [PMID: 22347671 PMCID: PMC3279960 DOI: 10.4103/2152-7806.92161] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 12/14/2011] [Indexed: 11/18/2022] Open
Abstract
Background: Rosai–Dorfman disease (RDD) was first described in 1969 as an idiopathic histiocytic proliferative disorder. It commonly presents as a massive and painless adenopathy. Until 1990, extranodal involvement of the central nervous system (CNS) was rare and reported in less than 5% of the total number of patients with extranodal RDD. Complete removal of CNS RDD has been achieved in many cases. Case Description: We report a case of an isolated intracranial RDD in a 53-year-old man. The patient had an episode of generalized seizures. Imaging studies of the brain were compatible with a meningioma en plaque. The mass was exposed by a right frontotemporal craniotomy. The tumor was adhered tightly to the adjacent cerebral cortex and was permeated by pial arteries of the brain surface. The sacrificing of these arteries was inevitable in order to achieve the total removal of the tumor. The patient had incomplete left hemiparesis after the surgery. Brain computed tomography (CT) imaging revealed a postoperative hemorrhage and a low-density lesion in the right frontal lobe. The patient was postoperatively diagnosed with isolated central nervous system RDD. Conclusion: Although the complete removal of dural-based lesions without any neurological deficits has been performed in many cases, the treatment of cases with high risks, such as the present case, indicates conservative excisions and adjuvant radiotherapy with or without chemotherapy.
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Affiliation(s)
- Ryosuke Tomio
- Department of Neurosurgery, School of Medicine, Keio University, Tokyo, Japan
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Wang F, Qiao G, Lou X, Song X, Chen W. Intracranial recurrences of Rosai-Dorfman disease in the sellar region: two illustrative cases. Acta Neurochir (Wien) 2011; 153:859-67. [PMID: 21161294 DOI: 10.1007/s00701-010-0895-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Accepted: 11/22/2010] [Indexed: 10/18/2022]
Abstract
Rosai-Dorfman disease [RDD] is a condition of an unknown etiology, characterized by proliferation of histiocytes. Not uncommonly extranodal lesions occur, but sellar involvement is very rare. Treatment of this lesion is complicated, especially in cases of recurrences at multiple intracranial sites. We report two cases of RDD in the sellar region with intracranial recurrences to illustrate the clinicopathological features and considerations of the optimal management.
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Rosai-Dorfman disease in neuroradiology: imaging findings in a series of 10 patients. AJR Am J Roentgenol 2011; 196:W187-93. [PMID: 21257861 DOI: 10.2214/ajr.10.4778] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Rosai-Dorfman disease is a rare disorder characterized histologically by lymphatic sinus dilatation due to histiocyte proliferation. Our goal was to describe the CT, MRI, and (18)F-FDG (FDG) PET findings in a series of patients with this diagnosis. MATERIALS AND METHODS We retrospectively reviewed the imaging studies of 10 patients with pathologically confirmed Rosai-Dorfman disease who were treated in our institution between January 2004 and December 2007. RESULTS We found the following areas of general involvement: three intracranial, seven head and neck, and three spinal, with some patients having more than one site. Specific sites of involvement included the following: intracranial meninges, n = 2; pituitary, n = 2; lacrimal gland, n = 1; paranasal sinus, n = 3; neck lymph nodes, n = 6; salivary gland, n = 3; tonsil, n = 1; skin, n = 1; spinal meninges, n = 2; vertebral body, n = 1; and thymus, n = 1. The MRI characteristics of the involved areas were generally T1 isointense, T2 isointense, diffusion isointense to gray matter, and intensely enhancing with gadolinium chelate contrast agents. CT images generally showed the lesions were hyperdense to gray matter and intensely enhancing. FDG PET showed variable uptake, with nodal and lacrimal disease generally being FDG avid and other sites not. CONCLUSION Rosai-Dorfman disease has a protean imaging appearance but most frequently presents as neck lymphadenopathy. The disease is frequently multifocal, and a diagnosis in one area should prompt suspicion that other sites may be involved also.
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Adeleye AO, Amir G, Fraifeld S, Shoshan Y, Umansky F, Spektor S. Diagnosis and management of Rosai-Dorfman disease involving the central nervous system. Neurol Res 2010; 32:572-8. [PMID: 20350368 DOI: 10.1179/016164109x12608733393836] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Rosai-Dorfman disease is a benign non-neoplastic proliferative disorder of histiocytes originally described in the cervical lymph nodes. Extranodal sites were later recognized, and by 1990, they were shown to represent over 40% of cases; however, central nervous system involvement is still considered rare. We review the literature, which shows a steady increase in reports of Rosai-Dorfman disease involving the brain and/or spine. METHODS A literature search was performed for the period 1969-2008, using multiple search engines, with keywords Rosai-Dorfman disease, central nervous system Rosai-Dorfman disease and sinus histiocytosis with massive lymphadenopathy. RESULTS By December 2008, 111 cases of Rosai-Dorfman disease involving the central nervous system had been reported in the literature, including our cases. In the central nervous system, Rosai-Dorfman disease is ubiquitous. Although it is characterized by unique, indeed pathognomonic, histopathological cytoarchitecture, it may be mistaken for many other neoplastic and inflammatory histioproliferative diseases. Surgical resection with post-operative corticosteroids remains the treatment of choice. CONCLUSIONS Rosai-Dorfman disease involving the central nervous system appears to be more common than previously thought and may well assume a more prominent place in the differential diagnoses of dural-based lesions. Expert awareness of the characteristic histopathology and immunohistochemistry of the disease is required for accurate diagnosis.
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Affiliation(s)
- Amos O Adeleye
- Division of Neurological Surgery, Department of Surgery, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
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Wang Y, Gao X, Tang W, Jiang C. Rosai-Dorfman disease isolated to the central nervous system: a report of six cases. Neuropathology 2009; 30:154-8. [PMID: 19703267 DOI: 10.1111/j.1440-1789.2009.01045.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We reviewed the diagnosis and treatment of six patients with CNS Rosai-Dorfman disease (RDD). Lesions were located in the cerebral convexity, middle cranial base, parasaggital, petrous orbit, and thoracic spine. Preoperatively, all the lesions were misdiagnosed as meningioma. Histopathology of all CNS lesions showed a characteristic feature called emperipolesis, where small lymphocytes or plasma cells were engulfed in histiocyte cytoplasm. Total resection of lesions was performed in all cases, and at an average follow-up of 15 months, all patients are alive and well with no evidence of recurrence. Preoperative diagnosis of CNS RDD is challenging. Surgical removal of lesions is an effective treatment. More research is needed to clarify the effectiveness of other treatment options such as radiosurgery and corticosteroid therapy.
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Affiliation(s)
- Yin Wang
- Department of Neuropathology, Hua-shan Hospital, Shanghai, China
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El Majdoub F, Brunn A, Berthold F, Sturm V, Maarouf M. Stereotactic interstitial radiosurgery for intracranial Rosai-Dorfman disease. A novel therapeutic approach. Strahlenther Onkol 2009; 185:109-12. [PMID: 19240997 DOI: 10.1007/s00066-009-1911-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Accepted: 10/22/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Rosai-Dorfman disease is an idiopathic, histoproliferative disorder characterized by massive painless lymphadenopathy. The favorable treatment of Rosai-Dorfman disease affecting the central nervous system is surgical resection. Histological and immunohistochemical confirmation is essential for a definitive diagnosis. CASE REPORT The authors report on a 10-year-old patient with Rosai-Dorfman disease of the central nervous system who presented with increased intracranial pressure. She was treated by stereotactic interstitial irradiation using iodine-125 seeds (interstitial radiosurgery). RESULT Stereotactic surgery was performed without complications. The patient recovered well to a normal neurologic status. MR images showed a complete remission 49 months after treatment. CONCLUSION The presented case demonstrates the high efficacy and safety of interstitial irradiation for intracranial Rosai-Dorfman disease. Hence, interstitial radiosurgery could be an appropriate therapeutic option for high-risk resectable intracranial Rosai-Dorfman disease.
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Affiliation(s)
- Faycal El Majdoub
- Department of Stereotactic and Functional Neurosurgery, University of Cologne, Köln, Germany
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Sinus Histiocytosis with Massive Lymphadenopathy (Rosai-Dorfman Disease): Imaging Manifestations in the Head and Neck. AJR Am J Roentgenol 2008; 191:W299-306. [DOI: 10.2214/ajr.08.1114] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Hinduja A, Giselle Aguilar L, Steineke T, Nochlin D, Landolfi JC. Rosai-Dorfman disease manifesting as intracranial and intraorbital lesion. J Neurooncol 2008; 92:117-20. [DOI: 10.1007/s11060-008-9733-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 11/03/2008] [Indexed: 11/28/2022]
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McPherson CM, Brown J, Kim AW, DeMonte F. Regression of intracranial rosai-dorfman disease following corticosteroid therapy. Case report. J Neurosurg 2006; 104:840-4. [PMID: 16703894 DOI: 10.3171/jns.2006.104.5.840] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Rosai-Dorfman disease (RDD) is an idiopathic histioproliferative disorder usually presenting with massive, painless lymphadenopathy. Extranodal involvement has been reported including at least 50 cases affecting the central nervous system (CNS). The treatment of CNS RDD as reported in the literature has primarily involved a surgical technique. The authors report on the case of a 53-year-old man presenting with multiple skull base lesions mimicking meningiomas. The patient suffered visual deterioration and underwent a right orbitopterional craniotomy as well as optic nerve decompression. Histopathological analysis revealed histiocytic cells and emperipolesis consistent with RDD. Following surgery, corticosteroid agents were administered, leading to marked resolution of both the remaining surgically untreated lesions and the balance of the patient's symptoms. This report represents the first case of the resolution of intracranial RDD following corticosteroid therapy. Corticosteroid agents should be considered an effective option in the treatment of CNS RDD.
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Affiliation(s)
- Christopher M McPherson
- Department of Neurosurgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009, USA
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Ruggiero A, Attinà G, Maurizi P, Mulè A, Tarquini E, Barone G, Lazzareschi I, Riccardi R. Rosai-Dorfman disease: two case reports and diagnostic role of fine-needle aspiration cytology. J Pediatr Hematol Oncol 2006; 28:103-6. [PMID: 16462585 DOI: 10.1097/01.mph.0000200686.33291.d1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Rosai-Dorfman disease, or sinus histiocytosis with massive lymphadenopathy (SHML), is a rare and self-limiting benign disorder that most commonly involves the cervical lymph nodes. The authors describe two cases of SHML. Fine-needle aspiration of the lymphadenopathy was performed in both patients. Immunocytochemical and histologic features, as the evidence of emperipolesis and S100 protein positivity on immunostaining, were typical of SHML. Fine-needle aspiration cytology plays an important diagnostic role in SHML and may be conclusive in a typical clinical setting. The diagnosis of SHML should be considered in the differential diagnosis of massive, painless cervical lymphadenopathy. Long-term follow-up is necessary to observe the complete regression of the massive lymphadenopathy. However, specific therapy is available and should be limited to patients with compressive symptoms or extranodal disease.
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Affiliation(s)
- Antonio Ruggiero
- Division of Pediatric Oncology, Catholic University, Rome, Italy.
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Yoon AJ, Parisien M, Feldman F, Young-In Lee F. Extranodal Rosai-Dorfman disease of bone, subcutaneous tissue and paranasal sinus mucosa with a review of its pathogenesis. Skeletal Radiol 2005; 34:653-7. [PMID: 16096753 DOI: 10.1007/s00256-005-0953-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2004] [Revised: 12/08/2004] [Accepted: 12/08/2004] [Indexed: 02/02/2023]
Abstract
We report an unusual case of extranodal Rosai-Dorfman disease presenting in a 36-year-old man with lesions of bone, subcutaneous tissue of the arm and maxillary sinus mucosa unassociated with lymphadenopathy or systemic symptoms. These lesions appeared metachronously within a 6-month period. The diagnostic light microscopic and immunohistochemical findings and pathogenesis of this interesting disease are discussed.
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Affiliation(s)
- Angela J Yoon
- Department of Pathology, Division of Surgical Pathology, College of Physicians and Surgeons, Columbia University Medical Center, 630 West 168th Street 1574, New York, NY 10032, USA.
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