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Qama E, Rodriguez CC, Sekhri R, Lu C, McAuliffe J, Bhalla A. Rosai-Dorfman Disease of pancreas: rare aetiology mimicking malignancy. J Clin Pathol 2024:jcp-2024-209412. [PMID: 39025489 DOI: 10.1136/jcp-2024-209412] [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: 04/02/2024] [Accepted: 06/07/2024] [Indexed: 07/20/2024]
Abstract
Rosai-Dorfman disease (RDD) is a non-Langerhans cell histiocytosis which usually presents as painless lymphadenopathy. Extranodal involvement is known to occur in various organs, and less than ten cases with primary pancreatic involvement have been reported previously. This case report details the clinical course of an elderly female, presenting with upper abdominal discomfort and imaging suggestive of malignancy. Multiple non-diagnostic fine-needle aspirations were followed by surgical intervention. Histopathological evaluation revealed a pancreatic mass with characteristic features of RDD. The large hallmark RDD histiocytes showed pale, watery-clear cytoplasm, central round nucleus, and prominent nucleolus, with and without lymphocyte emperipolesis. The RDD histiocytes showed positive immunostaining for CD68, CD163, S100 (nuclear and cytoplasmic), OCT-2, Cyclin D1 and are negative for CD1a, Factor XIIIa, fascin and langerin. This case underscores the importance of considering RDD in the differential diagnosis of pancreatic masses alongwith comprehensive evaluation, multidisciplinary approach and pancreatic core needle biopsy evaluation.
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Affiliation(s)
- Eros Qama
- Department of Surgical Pathology, Moses Division, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Radhika Sekhri
- Pathology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Chuanyong Lu
- Department of Surgical Pathology, Moses Division, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York, USA
| | - John McAuliffe
- Department of Surgical Pathology, Moses Division, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York, USA
| | - Amarpreet Bhalla
- Department of Surgical Pathology, Moses Division, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York, USA
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Hu PP, Wei F, Liu XG, Liu ZJ. Diagnosis and treatment of Rosai-Dorfman disease of the spine: a systematic literature review. Syst Rev 2021; 10:31. [PMID: 33461611 PMCID: PMC7814441 DOI: 10.1186/s13643-021-01581-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/02/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To review and summarize the clinical features, diagnosis, treatment strategies, and prognosis of spinal Rosai-Dorfman disease (RDD). METHODS RDD is also termed as sinus histiocytosis with massive lymphadenopathy. We searched the databases of PubMed, Elsevier ScienceDirect, SpringerLink, and OVID. The keywords were Rosai-Dorfman disease and spine/central nervous system. Research articles and case reports with accessibility to full texts regarding spinal RDD were eligible for the inclusion. A total of 62 articles were included, and they contained 69 cases. We extracted the information of interest and analyzed them using SPSS statistics package. RESULTS The average age was 33.1 ± 18.3 years. The ratio of males to females was 1.9/1. Overall, 63 cases presented with spine-related symptoms. A total of 27 cases (39.1%) had multi-organ lesions, and 12 cases had records of massive lymphadenopathy. Among 47 cases who first manifested spine-related symptoms, 93.6% were preoperatively misdiagnosed. The disease had a predilection for cervical spine (38.8%) and thoracic spine (40.3%). 62.9% of lesions were dura-based. Surgery remained the mainstream treatment option (78.8%), with or without adjuvant therapies. Total lesion resection was achieved in 34.8% of cases. The rate of lesion recurrence/progression was 19.5%, which was marginally lower for total resection than for non-total resection. CONCLUSION Spinal RDD has no pathognomonic clinical and imaging features. Most cases first present with spine-relevant symptoms. Massive lymphadenopathy is not common, but a tendency for multi-organ involvement should be considered. Spinal RDD has a high recurrence rate; thus, total resection is the treatment of choice. Adjuvant therapies are indicated for multi-organ lesions and residual lesions. A wait and watch strategy is recommended for asymptomatic patients. Herein, a workflow of diagnosis and treatment of the spinal RDD is established.
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Affiliation(s)
- Pan-Pan Hu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Feng Wei
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China.
| | - Xiao-Guang Liu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Zhong-Jun Liu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China
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Lin CK, Tsai YD. Nonresectable Thoracic Rosai-Dorfman Disease: A Case Report and Review of the Literature. World Neurosurg 2019; 132:309-313. [PMID: 31525482 DOI: 10.1016/j.wneu.2019.09.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/07/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Rosai-Dorfman disease (RDD) is a rare disease that can be triggered by either viral or bacterial infection. Several parts of the body can be involved, from the central nervous system to the pelvic regions had been reported. At present, there is a serious lack of guidelines as to how to treat cases of RDD involving the spine. Current trends show that surgery remains the first method of choice to cure this disease, but in refractory or recurrent RDD, repeat surgery cannot guarantee total resection. Under such circumstances, adjuvant therapy can be very useful. Here, we share our experience of treating recurrent spinal RDD. CASE DESCRIPTION Our patient was a 32-year-old male patient with hepatitis B virus infection. He suffered from lower back pain with lower limb weakness after being hit by a metal pipe. Laminectomy of T11-12 was performed to decompress the spinal cord. The final pathological results demonstrated chronic inflammation. After surgery, the lower limbs improved and the patient recovered quite well. However, he returned 3 years later with the same complaints and was diagnosed with RDD. Durectomy was performed and repaired with an artificial dura. Thalidomide therapy was initiated. Currently, 9 years later, the patient has not experienced recurrence or any form of neurological deficit. CONCLUSIONS RDD is a rare disease and can be misdiagnosed easily. Although it may resolve spontaneously, recurrence is possible. Hence, extensive follow-up is necessary. Surgery remained the first choice of surgery, however, when encountered recurrent or nonresectable RDD, adjuvant therapy such as corticosteroids, thalidomide, and radiotherapy could help. In this article, we shared our experience using thalidomide in treating nonresectable RDD.
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Affiliation(s)
- Cheng-Kai Lin
- Department of Neurosurgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Duan Tsai
- Department of Neurosurgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan.
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Brown A, Branson SV, Datoo O'Keefe GA. Extranodal Rosai-Dorfman of the Pancreas Presents with Bilateral Granulomatous Anterior Uveitis. Ocul Oncol Pathol 2018; 5:229-233. [PMID: 31367582 DOI: 10.1159/000493639] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 09/06/2018] [Indexed: 12/30/2022] Open
Abstract
Background/Aims To report a case of a 65-year-old female who presented with bilateral anterior granulomatous uveitis, which led to the diagnosis of Rosai-Dorfman Disease (RDD) and the discovery of an associated pancreatic mass. Methods This is a retrospective case report of a single patient. Results A 65-year-old African American Female received a full workup for bilateral anterior granulomatous uveitis and was found to have a pancreatic mass on imaging. Biopsy of this mass was diagnostic for RDD, a rare proliferative histiocytic disorder, which classically presents with painless cervical lymphadenopathy, leukocytosis, and hypergammaglobulinemia. Conclusion Although rare, ocular involvement, including eyelid and orbital masses, and anterior uveitis, can herald the development of other systemic manifestations or RDD and can aid in the diagnosis of this systemic disease.
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Affiliation(s)
- A'sha Brown
- Emory University School of Medicine, Emory Eye Center, Medical Retinal and Uveitis Fellow, Atlanta, Georgia, USA
| | - Sara V Branson
- Emory University School of Medicine, Emory Eye Center, Resident, Atlanta, Georgia, USA
| | - Ghazala A Datoo O'Keefe
- Emory University School of Medicine, Assistant Professor of Ophthalmology, Section of Vitreoretinal Surgery and Diseases, Section of Uveitis and Vasculitis, Atlanta, Georgia, USA
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Galgano MA, Goulart CR, Chisholm K, Hazen M, Stone S. Rapid-Onset Thoracic Myelopathy due to an Epidural Sarcoid-Like Lesion in a Pediatric Patient. World Neurosurg 2018; 111:377-380. [DOI: 10.1016/j.wneu.2017.12.185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 12/26/2017] [Accepted: 12/30/2017] [Indexed: 10/18/2022]
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Nemir J, Trninic I, Duric KS, Jakovcevic A, Mrak G, Paladino J. Extranodal right-optic nerve Rosai-Dorfman disease: A rare localization case report. Surg Neurol Int 2017; 7:S1158-S1162. [PMID: 28194305 PMCID: PMC5299147 DOI: 10.4103/2152-7806.196933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 06/17/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Rosai-Dorfman is a rare disease that usually occurs in young adults. It is characterized with massive painless cervical lymphadenopathy and histiocyte proliferation. Isolated intracranial involvement is extremely rare. Our aim is to present a new rare case of extranodal Rosai-Dorfman disease that involved the right optic nerve in a 4-year-old boy. CASE DESCRIPTION A 4-year-old boy with right-sided convergent strabismus and amblyopia lasting for 1 year was treated at the Department of pediatric ophthalmology. Initial optical fundus examination was normal. Examination repeated after 1 year noted the atrophy of the optic nerve papilla. Visual evoked potentials of the right eye showed normal findings of prechiasmatic visual pathway with severe dysfunction of the right optic nerve. Magnetic resonance imaging (MRI) of the brain and orbits showed expansive changed and elongated right optic nerve with contrast enhancement, and smaller lesion in the right temporal operculum region visible in T2 and fluid-attenuated inversion recovery sequence. Through small eyebrow "keyhole" osteoplastic frontoorbital craniotomy the fusiform enlarged (to 2 cm) right optic nerve was identified, resected between the eyeball and optic chiasm, and transferred for pathohistological analysis. Early postoperative course had no complications. Histological, immunohistochemical, and ultrastructural analyses revealed extranodal Rosai-Dorfman disease. Right periorbital edema was verified on the 7th postoperative day and regressed to supportive therapy. Control multi slice computed tomography (MSCT) and MRI of endocranium and orbits showed total tumor removal with no signs of complications. CONCLUSION Although rare, extranodular intracranial Rosai-Dorfman disease should be taken into account in the differential diagnosis of intracranial and intraorbital lesions, especially in the pediatric age group.
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Affiliation(s)
- Jakob Nemir
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
| | - Ines Trninic
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia; Department of Neurosurgery, Dubrovnik General Hospital, Dubrovnik, Croatia
| | - Kresimir S Duric
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
| | - Antonia Jakovcevic
- Department of Pathology, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
| | - Goran Mrak
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
| | - Josip Paladino
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
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Tu J, Li WT, Yang C. Rosai-Dorfman disease of the subdural spine with a long segment lesion: A case report and literature review. J Int Med Res 2017; 45:875-881. [PMID: 28173721 PMCID: PMC5536658 DOI: 10.1177/0300060516687228] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy is a rare benign disorder usually characterized by massive painless cervical lymphadenopathy and systemic manifestations. Extranodal involvement, especially spinal involvement, is extremely rare. We report a 41-year-old man who presented with only intermittent dorsodynia. His condition was diagnosed as non-specific inflammatory disease on the basis of preoperative puncture biopsy results. We performed total surgical resection. Histopathological findings showed distinctive emperipolesis and immunohistochemistry results were positive for cluster of differentiation CD68 and S100 and negative for CD1a. A good prognosis was confirmed at the 3-month follow-up visit. This is the first case of RDD of the subdural spine with such a long segment lesion. There is still no consensus regarding appropriate therapy for this type of RDD and the preoperative diagnosis remains challenging. The unusual presentation of our case serves as a reference when diagnosing and treating RDD.
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Affiliation(s)
- Ji Tu
- 1 Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Wen-Tian Li
- 2 Wuhan Institute of Biological Products Co. limited, Wuhan, Hubei Province, China
| | - Cao Yang
- 1 Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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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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[Unusual bilateral eyelid and orbital involvement in Rosai-Dorfman disease (a comprehensive literature review and case report)]. J Fr Ophtalmol 2016; 39:e221-e225. [PMID: 27634472 DOI: 10.1016/j.jfo.2016.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 05/24/2016] [Accepted: 05/30/2016] [Indexed: 11/21/2022]
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Extra Nodal Rosai-Dorfman Disease (Sinus Histiocytosis with Massive Lymphadenopathy) Presenting as Asymmetric Bilateral Optic Atrophy : An Atypical Ocular Presentation. Head Neck Pathol 2016; 10:414-7. [PMID: 27091209 PMCID: PMC4972768 DOI: 10.1007/s12105-016-0719-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 04/11/2016] [Indexed: 10/21/2022]
Abstract
Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy, SHML) is a rare, non-hereditary, benign histiocytic proliferative disorder, presenting as painless bilateral cervical lymphadenopathy, with systemic symptoms. Extra nodal manifestations have been reported in 28-43 % cases with rare ocular involvement. We report a case of a 57 year old female presenting with gradual progressive decrease of vision OU since 8 months associated with epistaxis. Fundus examination revealed established optic atrophy in right eye with features of chronic papilloedema in left eye suggestive of compressive lesion. CT of brain, paranasal sinuses confirmed the presence of homogenously enhancing mass in left ethmoid sinus, left sphenoid sinus extending into suprasellar region. The biopsy of this mass revealed extra nodal SHML with tissue sections being S100 and CD68 positive with emperipolesis noted. Here we describe this atypical ocular presentation of extra nodal SHML to highlight that this rare disease can manifest as an aggressive sight threatening entity, even in older age group.
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Rocha-Maguey J, Felix-Torrontegui JA, Cabrera-López M, Gutiérrez-Castro M, Montante-Montes de Oca D. A new case of cervical intramedullary sinus histiocytosis causing paraplegia and review of the literature. Surg Neurol Int 2016; 7:9. [PMID: 26862448 PMCID: PMC4743271 DOI: 10.4103/2152-7806.175070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 10/20/2015] [Indexed: 11/28/2022] Open
Abstract
Background: Rosai–Dorfman disease (RDD) is an uncommon, benign histiocytic proliferative disorder of unknown origin. It predominantly affects the lymph nodes, but can also be found extranodal in different organs. Nervous system involvement is rare, and the most cases are intracranial. Surgical treatment is indicated when the central nervous system (CNS) in compromised. Case Description: We herein describe the management of a 27-year-old woman who presented progressive spinal cord symptoms, secondary to an isolated intramedullary lesion, which had a histological confirmation of RDD. To our knowledge, this is the 6th case reported in English written manuscripts. We review these cases and analyze some of the literature concerning the disease. Conclusions: RDD shows some variability in the involvement of the entire neuraxis, and because its ability to mimic meningeal and primary brain tumors, it is essential to be aware of this entity and consider RDD in the differential diagnosis of various lesions of the CNS. The conclusive diagnosis must be obtained by histological methods, so surgical approaches have to be discussed. Although it is not considered as a malignancy, options for postoperative medical treatment are variable and include radiation, chemotherapy or maybe monoclonal antibodies for refractory or recurrent cases.
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Affiliation(s)
- Jesús Rocha-Maguey
- Department of Neurosurgery, Hospital General de Culiacán, Salvador Zubirán, México
| | | | - Myriam Cabrera-López
- Department of Anatomical Pathology, Hospital General de Culiacán, Salvador Zubirán, México
| | - Macrina Gutiérrez-Castro
- Department of Anatomical Pathologyl, Hospital Angeles de Culiacán Sinaloa, Salvador Zubirán, México
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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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Abou-Zeid AH, Herwadkar A, du Plessis D, Gnanalingham KK. Isolated extradural Rosai-Dorfman disease of the thoracic spine: a rare cause of spinal cord compression: case report. Neurosurgery 2011; 67:E514-5. [PMID: 20644383 DOI: 10.1227/01.neu.0000372203.38326.cf] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Rosai-Dorfman disease is a rare benign histiocytic disease of unknown origin that arises predominantly in lymph nodes with generalized fever and malaise but can affect a variety of organs. We describe a case of isolated Rosai-Dorfman disease causing thoracic cord compression. CLINICAL PRESENTATION A 24-year-old man presented with progressive spastic paraparesis. A magnetic resonance scan revealed an anteriorly placed extradural lesion of the T4-T7 thoracic spine causing cord compression. He was systemically well with no other disease. INTERVENTION The patient made a complete recovery after a limited T4-T7 laminectomy and biopsy of the lesion. Repeat magnetic resonance scan at 6 months revealed a further posteriorly placed lesion at the T8/9 level. More extensive posterior surgery was carried out with subtotal resection of the lesion with pedicle screw fixation. Histologically, all specimens revealed fibrous connective tissue infiltrated by histiocytic cells with CD68 and S100 positivity, confirming a diagnosis of Rosai-Dorfman disease. CONCLUSIONS This is a rare case of isolated Rosai-Dorfman disease causing thoracic cord compression. It should be considered among the differential diagnoses of extradural cord compression. Radiological features and treatment options are discussed.
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Affiliation(s)
- Ahmed H Abou-Zeid
- Department of Neurosurgery, Greater Manchester Neuroscience Centre, Salford Royal Hospital, Manchester, United Kingdom
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Paire V, Bossard C, Vabres B, Weber M, Péchereau A. Localisations orbitaires de la maladie de Rosai-Dorfman : série de trois cas consécutifs. J Fr Ophtalmol 2008; 31:673-82. [DOI: 10.1016/s0181-5512(08)74381-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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