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Auerbach A, Aguilera NS. The changing landscape of pediatric histiocytoses: Birth, life, and transdifferentiation of pediatric histiocytes. Semin Diagn Pathol 2023; 40:420-428. [PMID: 37258365 DOI: 10.1053/j.semdp.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/19/2023] [Indexed: 06/02/2023]
Abstract
Histiocytic neoplasms in the children are very rare, and histiocytoses can occur in the perinatal period. The presumed origins and presentation of specific histiocytoses in the pediatric age group are described. Common and newly described histiocytoses are presented including Langerhans cell histiocytosis, Rosai-Dorfman disease, histiocytic sarcoma, ALK positive histiocytosis, and hemophagocytic lymphohistiocytosis. Molecular findings common to pediatric histiocytoses are also discussed.
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Affiliation(s)
- Aaron Auerbach
- Joint Pathology Center, Silver Spring, MD, United States of America
| | - Nadine S Aguilera
- University of Virginia Health System, Charlottesville, VA, United States of America.
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2
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Pichler M, Thuile T, Eisendle K. A rare case of agminated juvenile Xanthogranuloma: Clinical and dermatoscopic evolution. J Eur Acad Dermatol Venereol 2023; 37:e418-e420. [PMID: 36178140 DOI: 10.1111/jdv.18618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/23/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Pichler
- Department of Dermatology, Venereology and Allergology, Academic Teaching Department of Medical University Innsbruck, Central Hospital Bolzano/Bozen, Bolzano, Italy
| | - Tobias Thuile
- Department of Dermatology, Venereology and Allergology, Academic Teaching Department of Medical University Innsbruck, Central Hospital Bolzano/Bozen, Bolzano, Italy
| | - Klaus Eisendle
- Department of Dermatology, Venereology and Allergology, Academic Teaching Department of Medical University Innsbruck, Central Hospital Bolzano/Bozen, Bolzano, Italy.,Claudiana Research, University Pool of Health-Care Professions Claudiana, Bolzano, Bozen, Italy
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3
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Francois RA, Randall GJ, Rudnick EW, Carstens SJ, Vincek V. Multiple papular xanthomas mimicking juvenile xanthogranulomas in an infant: A case report and review of the literature. J Cutan Pathol 2023; 50:1-7. [PMID: 35637637 DOI: 10.1111/cup.14244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/04/2022] [Accepted: 04/25/2022] [Indexed: 01/03/2023]
Affiliation(s)
- Rony A Francois
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.,Departments of Pathology and Dermatology, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Grant J Randall
- Division of Dermatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Eric W Rudnick
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Stephanie J Carstens
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Vladimir Vincek
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
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4
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Mariotti EB, Corrà A, Lemmi E, Laschi L, Aimo C, Quintarelli L, Volpi W, Nacci F, Verdelli A, Ruffo di Calabria V, Guiducci S, Caproni M. Multicentric Reticulohistiocytosis Associated with an Early Form of Systemic Lupus Erythematosus: A Case Report of a Rare Disease, with Mini Review of the Literature. J Clin Med 2022; 11:6529. [PMID: 36362761 PMCID: PMC9658768 DOI: 10.3390/jcm11216529] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/16/2022] [Accepted: 11/01/2022] [Indexed: 08/10/2023] Open
Abstract
Multicentric reticulohistiocytosis (MRH) is the most frequently described form of reticulohistiocytosis (RH), and it is classified as a class IIb non-Langerhans cell histiocytosis. It has been designated as multicentric, being characterized by multisystemic involvement. In fact, although mainly involving the skin, along with the joints, it is a systemic inflammatory condition potentially involving every internal organ. As MRH-related skin findings can mimic rheumatoid nodules or Gottron papules, the histopathology of the cutaneous lesions is often necessary for the correct diagnosis. Approximately one-third of MRH patients have confirmed concomitant autoimmune disorders. A wide variety of autoimmune disorders associated with the disease have been reported in the literature, suggesting immune dysfunction as a factor in the pathophysiology of MRH. A case of MRH associated with autoimmune manifestation is reported in the context of a mini review of the literature, with a focus on clinical presentation, treatments, and treatment outcomes. Moreover, eight cases of MRH associated with autoimmune diseases are briefly discussed.
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Affiliation(s)
| | - Alberto Corrà
- Section of Dermatology, Department of Health Sciences, University of Florence, 50125 Florence, Italy
| | - Elisa Lemmi
- Section of Anatomical Pathology, Department of Health Sciences, University of Florence, 50125 Florence, Italy
| | - Lucrezia Laschi
- Section of Anatomical Pathology, Department of Health Sciences, University of Florence, 50125 Florence, Italy
| | - Cristina Aimo
- Section of Dermatology, Department of Health Sciences, University of Florence, 50125 Florence, Italy
| | - Lavinia Quintarelli
- Rare Disease Skin Unit, Section of Dermatology, Azienda USL Toscana Centro, University of Florence, 50125 Florence, Italy
| | - Walter Volpi
- Section of Dermatology, Azienda USL Toscana Centro, 50125 Florence, Italy
| | - Francesca Nacci
- Section of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, 50125 Florence, Italy
| | - Alice Verdelli
- Section of Dermatology, Azienda USL Toscana Centro, 50125 Florence, Italy
| | | | - Serena Guiducci
- Section of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, 50125 Florence, Italy
| | - Marzia Caproni
- Rare Disease Skin Unit, Section of Dermatology, Azienda USL Toscana Centro, University of Florence, 50125 Florence, Italy
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5
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Salari B, Dehner LP. Juvenile and adult xanthogranuloma: A 30-year single-center experience and review of the disorder and its relationship to other histiocytoses. Ann Diagn Pathol 2022; 58:151940. [DOI: 10.1016/j.anndiagpath.2022.151940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/17/2022] [Indexed: 11/01/2022]
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6
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Rech KL, He R. Challenges in the Histopathologic Diagnosis of Histiocytic Neoplasms. J Natl Compr Canc Netw 2021; 19:1305-1311. [PMID: 34781270 DOI: 10.6004/jnccn.2021.7098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Abstract
Histiocytic neoplasms, including Langerhans cell histiocytosis (LCH), Erdheim-Chester disease (ECD), and Rosai-Dorfman disease (RDD), present a diagnostic challenge due to nonspecific fibroinflammatory infiltrates and a diverse clinical presentation. The pathologist can play a key role in classification of these disorders through multidisciplinary collaboration and correlation of pathologic features with clinical and radiologic findings. The histopathologic differential diagnosis is broad, requiring knowledge of the possible diagnoses at each specific anatomic site, and a careful assessment to exclude other inflammatory and neoplastic disorders. An immunohistochemistry panel including CD163, CD1a, langerin, S100, Factor XIIIa, OCT2, and BRAF V600E can provide definitive diagnosis in LCH and RDD, whereas ECD requires classic clinical features as well as confirmation of an activating MAPK pathway mutation by genetic studies.
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Affiliation(s)
- Karen L Rech
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Rong He
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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McClain KL, Bigenwald C, Collin M, Haroche J, Marsh RA, Merad M, Picarsic J, Ribeiro KB, Allen CE. Histiocytic disorders. Nat Rev Dis Primers 2021; 7:73. [PMID: 34620874 PMCID: PMC10031765 DOI: 10.1038/s41572-021-00307-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 12/18/2022]
Abstract
The historic term 'histiocytosis' meaning 'tissue cell' is used as a unifying concept for diseases characterized by pathogenic myeloid cells that share histological features with macrophages or dendritic cells. These cells may arise from the embryonic yolk sac, fetal liver or postnatal bone marrow. Prior classification schemes align disease designation with terminal phenotype: for example, Langerhans cell histiocytosis (LCH) shares CD207+ antigen with physiological epidermal Langerhans cells. LCH, Erdheim-Chester disease (ECD), juvenile xanthogranuloma (JXG) and Rosai-Dorfman disease (RDD) are all characterized by pathological ERK activation driven by activating somatic mutations in MAPK pathway genes. The title of this Primer (Histiocytic disorders) was chosen to differentiate the above diseases from Langerhans cell sarcoma and malignant histiocytosis, which are hyperproliferative lesions typical of cancer. By comparison LCH, ECD, RDD and JXG share some features of malignant cells including activating MAPK pathway mutations, but are not hyperproliferative. 'Inflammatory myeloproliferative neoplasm' may be a more precise nomenclature. By contrast, haemophagocytic lymphohistiocytosis is associated with macrophage activation and extreme inflammation, and represents a syndrome of immune dysregulation. These diseases affect children and adults in varying proportions depending on which of the entities is involved.
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Affiliation(s)
- Kenneth L McClain
- Texas Children's Cancer Center, Department of Paediatrics, Baylor College of Medicine, Houston, TX, USA.
| | - Camille Bigenwald
- Department of Oncological Sciences and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew Collin
- Human Dendritic Cell Lab, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Julien Haroche
- Department of Internal Medicine, Institut E3M French Reference Centre for Histiocytosis, Pitié-Salpȇtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Rebecca A Marsh
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, and University of Cincinnati, Cincinnati, OH, USA
| | - Miriam Merad
- Department of Oncological Sciences and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jennifer Picarsic
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Karina B Ribeiro
- Faculdade de Ciȇncias Médicas da Santa Casa de São Paulo, Department of Collective Health, São Paulo, Brazil
| | - Carl E Allen
- Texas Children's Cancer Center, Department of Paediatrics, Baylor College of Medicine, Houston, TX, USA
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8
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Choraria A, Andrei V, Rajakulasingam R, Saifuddin A. Musculoskeletal imaging features of non-Langerhans cell histiocytoses. Skeletal Radiol 2021; 50:1921-1940. [PMID: 33787962 DOI: 10.1007/s00256-021-03765-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 02/02/2023]
Abstract
The non-Langerhans cell histiocytoses (N-LCH) represent a group of rare diseases with different clinical presentations and imaging features to classical LCH. While there is a long list of entities, only few present with musculoskeletal soft tissue and osseous manifestations alongside the more commonly reported systemic findings. Erdheim-Chester disease (ECD) is typically seen in adults as bilateral and symmetrical long bone osteosclerosis. Rosai-Dorfman disease (RDD) is more commonly seen in children and young adults with bone involvement usually being a manifestation of extra-nodal disease. Primary osseous RDD is very rare, with both displaying rather non-specific imaging features of an expansile lucent lesion with or without an extra-osseous component. Juvenile xanthogranuloma (JXG) is a benign disorder typically seen in very young children. The most common imaging manifestation is a dermal or sub-dermal soft tissue mass. This article reviews the musculoskeletal imaging appearances of the commoner N-LCH.
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Affiliation(s)
- Anika Choraria
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - Vanghelita Andrei
- Department of Histopathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - Ramanan Rajakulasingam
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
| | - Asif Saifuddin
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
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9
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Progressive Nodular Histiocytosis: Report of a Case and Review of the Literature. Case Rep Pathol 2021; 2021:5531820. [PMID: 34567817 PMCID: PMC8463211 DOI: 10.1155/2021/5531820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
Progressive nodular histiocytosis (PNH) is a rare condition characterized by progressive eruption of multiple yellowish-brown papules and nodules on the skin and mucous membranes. We present the case of a 37-year-old Caucasian man with gradually increased appearance of nodular lesions on the forehead and right temple. These lesions were initially diagnosed as xanthomas and did not respond to intralesional injections of triamcinolone. Additional biopsy revealed an intense dermal infiltrate of foamy mononuclear epithelioid cells with a minor admixture of plasma cells, lymphocytes, and scattered multinucleated giant cells. On immunohistochemical staining, the lesional cells were positive for CD163 and CD68 and negative for CD1a, thus confirming a mononuclear-macrophage lineage. The clinical presentation and the histological impression lead to the diagnosis of PNH. This condition could be challenging, mimicking microscopically similar lesions of the non-Langerhans cell histiocytosis group. Although uncommon, PNH stands out due to its clinical and microscopic features and should be taken into consideration in the differential diagnosis of cutaneous histiocytoses.
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10
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Fasulo S, Alkomos MF, Pjetergjoka R, Mekheal EM, Awasthi S, Chittamuri S, Kumar V, Kumar M, Akmal A, Maroules M. Erdheim-Chester disease presenting at the central nervous system. AUTOPSY AND CASE REPORTS 2021; 11:e2021321. [PMID: 34540726 PMCID: PMC8432387 DOI: 10.4322/acr.2021.321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/10/2021] [Indexed: 11/23/2022] Open
Abstract
Erdheim-Chester disease is a rare non-Langerhans cell histiocytosis (LCH) that affects different body systems. It was recently recognized as a neoplastic disorder after identifying an activating mutation of the MAPK pathway. Neurological presentations of ECD are rare. We present a case of a 35-year-old male who presented to the emergency department with neck pain, headache and vomiting for 2 months; MRI showed multiple heterogeneous intracranial masses. Neurosurgery performed a suboccipital craniotomy, partially resected the cerebellar mass, and placed a parietal to frontal shunt catheter. Biopsy results from the cerebellar mass demonstrated cerebellar tissue involved by a diffuse proliferation of foamy histiocytes and spindle cells admixed with prominent lymphoplasmacytic infiltrate and positive for CD68, CD163, Factor XIIIa and Fascin. PET scan showed hypermetabolic uptake within the medullary portions of the diffuse abnormal lesions of the distal femurs, tibias, and fibulas, and cardiac MRI was nonsignificant. The patient was started on vemurafenib and continued to show improvement in a 3-month outpatient follow-up.
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Affiliation(s)
- Sydney Fasulo
- St. Joseph's University, Medical Center, Hematology and Oncology Department, Paterson, NJ, USA.,St. George's University, School of Medicine, Grenada, West Indies, Granada
| | - Mina Fransawy Alkomos
- St. Joseph's University, Medical Center, Internal Medicine Department, Paterson, NJ, USA
| | - Rovena Pjetergjoka
- St. Joseph's University, Medical Center, Internal Medicine Department, Paterson, NJ, USA
| | - Erinie M Mekheal
- St. Joseph's University, Medical Center, Internal Medicine Department, Paterson, NJ, USA
| | - Sharon Awasthi
- St. Joseph's University, Medical Center, Internal Medicine Department, Paterson, NJ, USA
| | - Sahithi Chittamuri
- St. Joseph's University, Medical Center, Hematology and Oncology Department, Paterson, NJ, USA
| | - Vinod Kumar
- St. Joseph's University, Medical Center, Hematology and Oncology Department, Paterson, NJ, USA
| | - Mehandar Kumar
- St. Joseph's University, Medical Center, Hematology and Oncology Department, Paterson, NJ, USA
| | - Amer Akmal
- St. Joseph's University, Medical Center, Pathology Department, Paterson, NJ, USA
| | - Michael Maroules
- St. Joseph's University, Medical Center, Hematology and Oncology Department, Paterson, NJ, USA
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11
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Jeon I, Choi JH. Isolated thoracic intramedullary Erdheim-Chester disease presenting with paraplegia: a case report and literature review. BMC Musculoskelet Disord 2021; 22:270. [PMID: 33711983 PMCID: PMC7955615 DOI: 10.1186/s12891-021-04061-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/08/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Erdheim-Chester disease (ECD) is a rare, idiopathic, systemic non-Langerhans cell histiocytosis involving long bone and visceral organs. Central nervous system (CNS) involvement is uncommon and most cases develop as a part of systemic disease. We present a rare case of variant ECD as an isolated intramedullary tumor. CASE PRESENTATION A 75-year-old female patient with a medical history of diabetes and hypertension presented with sudden-onset flaccid paraparesis for 1 day. Neurological examination revealed grade 2-3 weakness in both legs, decreased deep tendon reflex, loss of anal tone, and numbness below T4. Leg weakness deteriorated to G1 before surgery. Preoperative magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) showed an intramedullary mass lesion at T2-T4 with no systemic lesion, which was heterogeneous enhancement pattern with cord swelling and edema from C7 to T6. Gross total removal was achieved for the white-gray-colored and soft-natured intramedullary mass lesion with an ill-defined boundary. Histological finding revealed benign histiocytic proliferation with foamy histiocytes and uniform nuclei. We concluded it as an isolated intramedullary ECD. The patient showed self-standing and walkable at 18-month with no evidence of recurrence and new lesion on spine MRI and whole-body FDG-PET/CT until sudden occurrence of unknown originated thoracic cord infarction. CONCLUSIONS We experienced an extremely rare case of isolated intramedullary ECD, which was controlled by surgical resection with no adjuvant therapy. Histological examination is the most important for final diagnosis, and careful serial follow-up after surgical resection is required to identify the recurrence and progression to systemic disease.
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Affiliation(s)
- Ikchan Jeon
- Department of Neurosurgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Hyeonchung street 170, 42415, Daegu, South Korea.
| | - Joon Hyuk Choi
- Department of Pathology, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, South Korea
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12
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Bonometti A. The triptych of mixed histiocytosis: a systematic review of 105 cases and proposed clinical classification. Leuk Lymphoma 2020; 62:32-44. [PMID: 32969291 DOI: 10.1080/10428194.2020.1824070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Histiocytoses are one of the ultimate diagnostic challenges that every physician face at least once in his/her life. Giving their protean manifestation and differentiated therapeutic needs, histiocytosis requires extensive characterization and multidisciplinary management. Mixed histiocytosis is an emerging group of syndromes defined by the overlap of Langerhans cell histiocytosis and another histiocytic disorder of different type. Despite rare, it may account for up to a fifth of systemic histiocytosis patients in some series. In this work, we comprehensively review for the first time the clinical, radiological, histopathological and molecular features of mixed histiocytosis in children and adults. Moreover, we propose a clinical classification in three groups that differentiate patients with systemic involvement and worse overall survival to other groups with more localized manifestations and indolent behavior, wanting to ease their recognition and treatment. Interestingly we also found that mixed histiocytosis harbor BRAFV600E mutations with a higher frequency comparing to all other histiocytoses, and may therefore benefit of specific inhibitory drugs.
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Affiliation(s)
- Arturo Bonometti
- Unit of Anatomic Pathology, Department of Molecular Medicine, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
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13
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Bonometti A, Berti E. Reticulohistiocytoses: a revision of the full spectrum. J Eur Acad Dermatol Venereol 2020; 34:1684-1694. [PMID: 31955466 DOI: 10.1111/jdv.16214] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/31/2019] [Indexed: 12/11/2022]
Abstract
Reticulohistiocytoses (RH) are rare and clinically heterogeneous histiocytic disorders of dermatological interest. Three clinical entities with superimposable histopathological features are currently considered, namely solitary reticulohistiocytoma, diffuse/generalized reticulohistiocytosis and multicentric reticulohistiocytosis. Although in the last decade, RH studies have only minimally progressed, histiocytosis research has advanced considerably: the prognostic and therapeutic importance of the clinical subclassification of histiocytosis patients as well as of the detection of genetic alterations in the genes of the ERK pathway has been highlighted. According to these insights, we previously reported the presence of molecular alteration RH and described a subset of patients with disseminated multisystem involvement lacking arthritis. In the present review, we aim to update and revise the knowledge regarding RH. We first reviewed their histopathological, immunophenotypical and ultrastructural features, discussed their histopathological differential diagnosis with other conditions characterized by infiltrates made of oncocytic or epithelioid cells (with special regard to Destombes-Rosai-Dorfman disease) and finally summarized the molecular landscape of RH. We therefore tried to adjust the clinical subclassification of Langerhans cell histiocytosis to the clinical phenotypes of RH, outlining five clinically different groups of patients. Finally, we reconsidered the clinical workflow to the evaluation of RH patients, in light of the 5 different clinical groups and discussed the different therapeutic approaches and the possible role of target inhibitors.
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Affiliation(s)
- A Bonometti
- Unit of Anatomic Pathology, Department of Molecular Medicine, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - E Berti
- Unit of Dermatology, IRCCS Ca' Granda - Maggiore Policlinico Hospital Foundation, University of Milan, Milan, Italy
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14
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AlQazlan S, Albakr A, Al Towim A, Alsaadan Y, Hassan H, Aljerian K, Elwatidy S. Aggressive surgical management of recurrent intracranial juvenile xanthogranuloma: case report and review of the literature. Childs Nerv Syst 2020; 36:213-217. [PMID: 31385088 DOI: 10.1007/s00381-019-04323-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/28/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Juvenile xanthogranuloma (JXG) with the central nervous system (CNS) involvement is a rare disease entity that remains poorly understood, especially when the condition develops following treatment for Langerhans cell histiocytosis (LCH). CASE REPORT A 21-year-old man who was diagnosed with LCH at age 2, several years following which he developed signs and symptoms of CNS involvement. Magnetic resonance imaging (MRI) of the brain revealed JXG with bilateral choroid plexus involvement. As radiation therapy for the intraventricular masses proved unsuccessful, he underwent two surgical resections. In the following years, he developed another large JXG in the meninges, which was managed conservatively until he required surgery due to symptom progression. Twelve years after the first surgery, the patient is in stable condition with no evidence of recurrence. CONCLUSION Due to the rarity of JXG in the CNS, optimal treatment strategies and the precise duration of therapy remain to be determined. Future studies should aim to develop an appropriate treatment algorithm for such rare cases.
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Affiliation(s)
- Salman AlQazlan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Albakr
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia. .,Division of Neurosurgery, Department of Neurosciences, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada.
| | - Abdullah Al Towim
- Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Yazeed Alsaadan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hamdy Hassan
- Department of Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khaldoon Aljerian
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sherif Elwatidy
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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15
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Sanchez-Alvarez C, Sandhu AS, Crowson CS, Wetter DA, McKenzie GA, Lehman JS, Makol A. Multicentric reticulohistiocytosis: the Mayo Clinic experience (1980–2017). Rheumatology (Oxford) 2019; 59:1898-1905. [DOI: 10.1093/rheumatology/kez555] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/17/2019] [Indexed: 01/04/2023] Open
Abstract
Abstract
Objectives
Multicentric reticulohistiocytosis (MRH), a rare histiocytic disease that can mimic other rheumatic conditions, may be associated with cancer and other autoimmune disorders. To better understand the disorder and its other associations, we aimed to evaluate clinical correlates and outcomes of all patients with MRH seen at Mayo Clinic, Rochester between 1980 and 2017.
Methods
A retrospective medical record review was conducted to identify all patients with MRH between 1 January 1980 and 30 April 2017.
Results
We identified 24 patients with biopsy-proven MRH (58% female, 75% Caucasian, median age at diagnosis 52 years, median follow-up of 2.3 years). All patients had cutaneous and articular involvement; 23 (96%) patients had papulonodular skin lesions (87% periungual and dorsal hand) and seven (30%) mucosal nodules; and 22 (92%) patients had arthralgias, 21 (88%) joint effusions and 13 (54%) synovitis. Most frequently used therapies included corticosteroids, cyclophosphamide, methotrexate and bisphosphonates. Biologics were used in four patients. Nine patients had symptomatic resolution at 1 year and 12 partial improvement. Radiological findings included erosive changes in three (60%) patients and arthritis mutilans in two patients (40%). Twenty-nine per cent of patients had a concomitant autoimmune disease and 25% malignancy including melanoma, endometrial, peritoneal and lung carcinoma. The 5-year survival rate was 85% (95% CI: 74, 100%).
Conclusion
To our knowledge, this is the largest single-centre series of patients with MRH highlighting the rarity of the condition and an unmet need for treatment options that can allow sustained disease remission. It also highlights the need for a high vigilance for malignancy and autoimmune diseases.
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Affiliation(s)
| | | | - Cynthia S Crowson
- Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - David A Wetter
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | | | - Julia S Lehman
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Ashima Makol
- Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
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16
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Picarsic J, Pysher T, Zhou H, Fluchel M, Pettit T, Whitehead M, Surrey LF, Harding B, Goldstein G, Fellig Y, Weintraub M, Mobley BC, Sharples PM, Sulis ML, Diamond EL, Jaffe R, Shekdar K, Santi M. BRAF V600E mutation in Juvenile Xanthogranuloma family neoplasms of the central nervous system (CNS-JXG): a revised diagnostic algorithm to include pediatric Erdheim-Chester disease. Acta Neuropathol Commun 2019; 7:168. [PMID: 31685033 PMCID: PMC6827236 DOI: 10.1186/s40478-019-0811-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 09/14/2019] [Indexed: 02/06/2023] Open
Abstract
The family of juvenile xanthogranuloma family neoplasms (JXG) with ERK-pathway mutations are now classified within the "L" (Langerhans) group, which includes Langerhans cell histiocytosis (LCH) and Erdheim Chester disease (ECD). Although the BRAF V600E mutation constitutes the majority of molecular alterations in ECD and LCH, only three reported JXG neoplasms, all in male pediatric patients with localized central nervous system (CNS) involvement, are known to harbor the BRAF mutation. This retrospective case series seeks to redefine the clinicopathologic spectrum of pediatric CNS-JXG family neoplasms in the post-BRAF era, with a revised diagnostic algorithm to include pediatric ECD. Twenty-two CNS-JXG family lesions were retrieved from consult files with 64% (n = 14) having informative BRAF V600E mutational testing (molecular and/or VE1 immunohistochemistry). Of these, 71% (n = 10) were pediatric cases (≤18 years) and half (n = 5) harbored the BRAF V600E mutation. As compared to the BRAF wild-type cohort (WT), the BRAF V600E cohort had a similar mean age at diagnosis [BRAF V600E: 7 years (3-12 y), vs. WT: 7.6 years (1-18 y)] but demonstrated a stronger male/female ratio (BRAF V600E: 4 vs WT: 0.67), and had both more multifocal CNS disease ( BRAFV600E: 80% vs WT: 20%) and systemic disease (BRAF V600E: 40% vs WT: none). Radiographic features of CNS-JXG varied but typically included enhancing CNS mass lesion(s) with associated white matter changes in a subset of BRAF V600E neoplasms. After clinical-radiographic correlation, pediatric ECD was diagnosed in the BRAF V600E cohort. Treatment options varied, including surgical resection, chemotherapy, and targeted therapy with BRAF-inhibitor dabrafenib in one mutated case. BRAF V600E CNS-JXG neoplasms appear associated with male gender and aggressive disease presentation including pediatric ECD. We propose a revised diagnostic algorithm for CNS-JXG that includes an initial morphologic diagnosis with a final integrated diagnosis after clinical-radiographic and molecular correlation, in order to identify cases of pediatric ECD. Future studies with long-term follow-up are required to determine if pediatric BRAF V600E positive CNS-JXG neoplasms are a distinct entity in the L-group histiocytosis category or represent an expanded pediatric spectrum of ECD.
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Affiliation(s)
- J Picarsic
- Department of Pathology, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
| | - T Pysher
- Department of Pathology, University of Utah, Primary Children's Hospital, Salt Lake City, UT, USA
| | - H Zhou
- Department of Pathology, University of Utah, Primary Children's Hospital, Salt Lake City, UT, USA
| | - M Fluchel
- Department of Pediatric Hematology-Oncology, University of Utah, Primary Children's Hospital, Salt Lake City, UT, USA
| | - T Pettit
- Children's Hematology Oncology Centre, Christchurch Hospital, Christchurch, New Zealand
| | - M Whitehead
- Department of Pathology, Christchurch Hospital, Christchurch, New Zealand
| | - L F Surrey
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - B Harding
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - G Goldstein
- Department of Pediatric Hematology-Oncology, Hadassah University Hospital, Jerusalem, Israel
| | - Y Fellig
- Department of Pathology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - M Weintraub
- Acquired Brain Injury Service, Alyn Pediatric and Adolescent Rehabilitation Hospital, Jerusalem, Israel
| | - B C Mobley
- Department of Pathology, Vanderbilt Hospital, Nashville, USA
| | - P M Sharples
- Department of Pediatric Neurology, Bristol Royal Hospital for Children, Bristol, England
| | - M L Sulis
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York City, USA
| | - E L Diamond
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - R Jaffe
- Department of Pathology, University of Pittsburgh School of Medicine, UPMC Magee Women's Hospital, Pittsburgh, PA, USA
| | - K Shekdar
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - M Santi
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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17
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Höck M, Zelger B, Schweigmann G, Brunner B, Zelger B, Kropshofer G, Kiechl-Kohlendorfer U. The various clinical spectra of juvenile xanthogranuloma: imaging for two case reports and review of the literature. BMC Pediatr 2019; 19:128. [PMID: 31018833 PMCID: PMC6482499 DOI: 10.1186/s12887-019-1490-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 04/05/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Juvenile xanthogranuloma (JXG) belongs to the heterogeneous group of non-Langerhans cell histiocytosis and is caused by an accumulation and proliferation of macrophages. In the majority of cases JXG is a disorder of early childhood presenting during the first 2 years of life. The typical presentation is a solitary reddish or yellowish skin papule or nodule with spontaneous regression and no need for treatment. CASE PRESENTATION Two infants with an atypical presentation of JXG, one with multiple blueberry muffin rash-like skin lesions and the other with severe multi-systemic involvement, are reported. Diagnosis was established by skin biopsy including histological work-up and immunostaining, where markers for macrophages (CD68 and CD163) exhibited significant reactivity. CONCLUSION JXG is the most common of the non-Langerhans cell histiocytosis. The typical presentation is a solitary skin lesion. The purpose of this report is to familiarize paediatricians with an unusual variant of this entity in order to facilitate early diagnosis and raise awareness for possible visceral complications and associated medical conditions.
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Affiliation(s)
- Michaela Höck
- Department of Paediatrics II Neonatology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Bernhard Zelger
- Department of Dermatology and Venerology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gisela Schweigmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Brunner
- Department of Paediatrics II Neonatology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Bettina Zelger
- Department of Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gabriele Kropshofer
- Department of Paediatrics I Oncology, Medical University of Innsbruck, Innsbruck, Austria
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18
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Rodríguez-Velasco A, Rodríguez-Zepeda MDC, Ortiz-Hidalgo C. Infantile systemic juvenile xanthogranuloma case with massive liver infiltration. Autops Case Rep 2019; 9:e2018081. [PMID: 31086776 PMCID: PMC6455703 DOI: 10.4322/acr.2018.081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/04/2019] [Indexed: 11/24/2022]
Abstract
Infantile systemic juvenile xanthogranuloma (ISJXG) is an uncommon form of juvenile xanthogranuloma, a non-Langerhans cell proliferation of infancy and early childhood. In a small percentage of patients, the visceral involvement—most commonly to the central nervous system, liver, spleen, or lungs—may be associated with severe morbidity, and eventually fatal outcome. Here we describe the clinical and pathological findings of a 28-day-old girl with ISJXG who died with respiratory distress syndrome. She had few cutaneous lesions but massive liver and spleen infiltration; other affected organs were multiple lymph nodes, thoracic parasympathetic nodule, pleura, pancreas, and kidneys. Additional findings were mild pulmonary hypoplasia and bacteremia. Immunohistochemistry on fixed tissues is the standard for diagnosis. Immunophenotype cells express CD14, CD68, CD163, Factor XIIIa, Stabilin-1, and fascin; S100 was positive in less than 20% of the cases; CD1a and langerin were negative. No consistent cytogenetic or molecular genetic defect has been identified. This case demonstrates that the autopsy is a handy tool, because hepatic infiltration, which was not considered clinically, determined a restrictive respiratory impairment. In our opinion, this was the direct cause of death.
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Affiliation(s)
- Alicia Rodríguez-Velasco
- UMAE, Hospital de Pediatría del Centro Médico Nacional IMSS, Department of Pathology. Ciudad de México, Mexico
| | | | - Carlos Ortiz-Hidalgo
- Hospital ABC Medical Center, Department of Surgical Pathology. Ciudad de México, Mexico
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19
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Bonometti A, Sacco G, De Juli E, Invernizzi R, Venegoni L, Bagnoli F, Moltrasio C, Passoni E, Bellistri F, Bianchi P, Alaibac M, Paulli M, Berti E. Multisystem non‐arthropathic reticulohistiocytosis: problems and pitfalls in the differential diagnosis of multisystem non‐Langerhans‐cell histiocytoses. J Eur Acad Dermatol Venereol 2019; 33:e195-e198. [DOI: 10.1111/jdv.15461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- A. Bonometti
- Unit of Anatomic Pathology Department of Molecular Medicine IRCCS San Matteo Foundation University of Pavia Via Forlanini 14 27100 Pavia Italy
| | - G. Sacco
- Unit of Dermatology University of Padua Via Gallucci, 4 35121 Padua Italy
| | - E. De Juli
- Division of Pneumology ASST Grande Ospedale Metropolitano Niguarda Piazza Ospedale Maggiore, 3 20162 Milan Italy
| | - R. Invernizzi
- Department of Internal Medicine IRCCS Policlinico San Matteo Foundation University of Pavia Viale Golgi 16 27100 Pavia Italy
| | - L. Venegoni
- Department of Pathophysiology and Transplantation Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Via Pace, 9 20122 Milan Italy
| | - F. Bagnoli
- Department of Oncology and Hematology University of Milan Via Festa del Perdono, 7 20122 Milan Italy
| | - C. Moltrasio
- Unit of Dermatology IRCCS Ca’ Granda ‐ Maggiore Policlinico Hospital Foundation Milan University of Milan Via Pace, 9 20122 Milan Italy
| | - E. Passoni
- Unit of Dermatology IRCCS Ca’ Granda ‐ Maggiore Policlinico Hospital Foundation Milan University of Milan Via Pace, 9 20122 Milan Italy
| | - F. Bellistri
- Department of Internal Medicine IRCCS Policlinico San Matteo Foundation University of Pavia Viale Golgi 16 27100 Pavia Italy
| | - P. Bianchi
- Department of Oncohematology Anemia Pathophysiology Section Fondazione IRCCS Ca’ Granda Ospedale Maggiore di Milano Via Mangiagalli 32 Milan Italy
| | - M. Alaibac
- Unit of Dermatology University of Padua Via Gallucci, 4 35121 Padua Italy
| | - M. Paulli
- Unit of Anatomic Pathology Department of Molecular Medicine IRCCS San Matteo Foundation University of Pavia Via Forlanini 14 27100 Pavia Italy
| | - E. Berti
- Department of Pathophysiology and Transplantation Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Via Pace, 9 20122 Milan Italy
- Department of Oncology and Hematology University of Milan Via Festa del Perdono, 7 20122 Milan Italy
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20
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Mori H, Nakamichi Y, Takahashi K. Multiple Juvenile Xanthogranuloma of the Eyelids. Ocul Oncol Pathol 2018; 4:73-78. [PMID: 30320084 PMCID: PMC6170914 DOI: 10.1159/000478101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 05/26/2017] [Indexed: 12/23/2022] Open
Abstract
Juvenile xanthogranuloma (JXG) is a rare and benign tumor in infants. A solitary lesion on the eyelid has been reported in patients with JXG. We report a 15-year-old boy with multiple involvement of JXG on both eyelids. A mass on the left inner canthus was resected because of disturbance of the visual field and a risk of malignancy in terms of central ulceration in the lesion. The mass was examined by light microscopy. The mass had Touton giant cells with a wreath of nuclei surrounded by foamy histiocytes. No malignancy was observed. The mass showed no recurrence after resection.
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Affiliation(s)
- Hidetsugu Mori
- Department of Ophthalmology, Kansai Medical University, Osaka, Japan
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21
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Lee TK, Jung TY, Baek HJ, Kim SK, Lee KH, Yun SJ. Disseminated juvenile xanthogranuloma occurring after treatment of Langerhans cell histiocytosis: a case report. Childs Nerv Syst 2018; 34:765-770. [PMID: 29209883 DOI: 10.1007/s00381-017-3675-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 11/27/2017] [Indexed: 10/18/2022]
Abstract
CASE PRESENTATION An 11-year-old boy presented with a complaint of a painful temporal mass. Brain magnetic resonance imaging (MRI) showed a 3-cm-sized, homogeneously enhancing mass in the greater wing of the left sphenoid bone, which was diagnosed as Langerhans cell histiocytosis (LCH). Chemotherapy with vincristine and prednisolone was performed for 1 year. After 1 year and 11 months off treatment, he developed symptoms such as polydipsia and polyuria. Brain MRI showed thickening of the pituitary stalk with enhancement, suggestive of LCH involvement, and no recurrence in the sphenoid bone. After 4 years and 4 months off treatment, he developed multiple, subcutaneous, asymptomatic, and yellowish variable-sized papules on his face, posterior neck, and back, which were pathologically diagnosed as juvenile xanthogranuloma (JXG). Brain MRI revealed multifocal enhancing skull lesions in the left parietal, right frontal, and left occipital bones, which were also diagnosed as JXG. After 5 years and 8 months off treatment, the number of variable-sized skin lesions was increased without changes in the lesions in the skull and pituitary stalk. CONCLUSION We report a case of disseminated JXG occurring after treatment of LCH. These clinical co-presentations suggested a close relationship between their pathogenesis.
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Affiliation(s)
- Tae-Kyu Lee
- Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do, 519-809, Republic of Korea
| | - Tae-Young Jung
- Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do, 519-809, Republic of Korea.
| | - Hee-Jo Baek
- Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do, 519-809, Republic of Korea.
| | - Seul-Kee Kim
- Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kyung-Hwa Lee
- Department of Pathology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea
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22
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Abstract
This article focuses on cutaneous hematopoietic neoplasms that are more likely to be encountered in the pediatric age-group and includes both lymphoproliferative and histiocytic disorders. The cutaneous hematologic disorders in children have a different epidemiologic profile to what is seen during adulthood. Although mycosis fungoides is the most frequent form of cutaneous lymphoma in adults, it is very rare in children. Because lymphoblastic leukemias and lymphomas are more frequent in the pediatric setting, cutaneous leukemic infiltrates are relatively common in this age-group. Similarly, histiocytic disorders are more common in children, particularly Langerhans cell histiocytosis and juvenile xanthogranuloma. Notably, the histiocytic disorders have undergone significant modifications on their nomenclature in the basis of the molecular characteristics that are present in them. A summary of the most frequent cutaneous hematopoietic disorders in children will be discussed further in this review.
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Affiliation(s)
- Alejandro A Gru
- 1 Department of Pathology, University of Virginia, Charlottesville, Virginia
| | - Louis P Dehner
- 2 Lauren V. Ackerman Laboratory of Surgical Pathology, St. Louis Children's Hospital and Dermatopathology, Washington University Medical Center, St. Louis, Missouri
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23
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Wagner KM, Mandel JJ, Goodman JC, Gopinath S, Patel AJ. Intracranial Erdheim-Chester Disease Mimicking Parafalcine Meningioma: Report of Two Cases and Review of the Literature. World Neurosurg 2017; 110:365-370. [PMID: 29191545 DOI: 10.1016/j.wneu.2017.11.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Erdheim-Chester disease (ECD) is a rare, non-Langerhans cell histiocytosis that typically occurs in middle-aged patients. It is usually characterized by multifocal osteosclerotic lesions of the long-bones, however many cases have extraskeletal involvement. Central nervous system (CNS) involvement is common, but isolated CNS involvement at presentation has rarely been reported. CASE DESCRIPTION Here we report two cases of dural-based ECD mimicking meningioma on imaging with no other identified sites of disease. CONCLUSION ECD is a rare disease, with isolated CNS involvement reported only a few times in the literature. The significance of this presentation requires additional study and long-term follow up.
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Affiliation(s)
- Kathryn M Wagner
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Jacob J Mandel
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - J Clay Goodman
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Shankar Gopinath
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Akash J Patel
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
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24
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Cullen D, Cullen R, Jo-Velasco M, Queriolo A, Requena L. Asymptomatic cutaneous lesions with zosteriform distribution. Clin Exp Dermatol 2017; 43:83-87. [PMID: 28944488 DOI: 10.1111/ced.13224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2017] [Indexed: 11/26/2022]
Affiliation(s)
- D Cullen
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - R Cullen
- Department of Dermatology, Universidad de Chile, Santiago, Chile
| | - M Jo-Velasco
- Department of Pathology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - A Queriolo
- Department of Internal Medicine, Universidad de Chile, Santiago, Chile
| | - L Requena
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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25
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Pacifico A, Leone G, Damiani G, Ferraro C, Iacovelli P, Paro Vidolin A, Muscardin L. Indeterminate cell histiocytosis: A case treated with ultraviolet B narrow band phototherapy (NB UVB). PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 33:329-333. [DOI: 10.1111/phpp.12327] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | - Giovanni Leone
- San Gallicano Dermatological Institute; IRCCS; Rome Italy
| | - Giovanni Damiani
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti; Unità Operativa di Dermatologia; IRCCS Fondazione Cà Granda; Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milano Italy
| | | | | | | | - Luca Muscardin
- San Gallicano Dermatological Institute; IRCCS; Rome Italy
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26
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Baykal C, Polat Ekinci A, Yazganoglu KD, Buyukbabani N. The clinical spectrum of xanthomatous lesions of the eyelids. Int J Dermatol 2017; 56:981-992. [PMID: 28500693 DOI: 10.1111/ijd.13637] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 03/10/2017] [Accepted: 03/21/2017] [Indexed: 12/11/2022]
Abstract
Yellowish papules, nodules, or plaques, namely "xanthomatous" lesions, may be seen on the eyelids in the course of various disorders. The prototype is "xanthelasma palpebrarum" (XP) that is localized only to the eyelids and may be associated with hyperlipidemia. On the other hand, different types of normolipemic disorders may also cause xanthomatous eyelid lesions. Among these, Langerhans cell histiocytosis, diffuse normolipemic xanthoma, and non-Langerhans cell histiocytoses (papular xanthoma, juvenile xanthogranuloma, xanthoma disseminatum, adult-onset xanthogranuloma, adult-onset asthma and periocular xanthogranuloma, necrobiotic xanthogranuloma, Erdheim-Chester disease, Rosai-Dorfman disease, and reticulohistiocytosis) can be listed. The eyelid findings of this heterogeneous group of disorders are challenging to differentiate from each other due to common clinical aspects that may even sometimes mimic XP. Nodularity, induration, ulceration, diffuse eyelid involvement, and extension from eyelids to the neighboring skin may represent the clinical features of xanthomatous lesions other than XP. It is necessary to obtain a thorough history and exclude XP and then perform detailed dermatological and systemic examination, biopsy for histopathologic confirmation, and appropriate specific imaging screens. As some of the conditions may be associated with other systemic disorders, especially malignancies, the differentiation of xanthomatous eyelid lesions has a critical importance, and clinical signs can be guiding.
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Affiliation(s)
- Can Baykal
- Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Algun Polat Ekinci
- Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Kurtulus D Yazganoglu
- Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Nesimi Buyukbabani
- Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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27
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Chikin VV, Znamenskaja LF, Karamova AJE, Smol'jannikova VA, Nefedova MA. Generalized eruptive histiocytoma: case report. VESTNIK DERMATOLOGII I VENEROLOGII 2017. [DOI: 10.25208/0042-4609-2017-93-1-55-63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The case of generalized eruptive histiocytoma (GEH) in woman of 49 years old is reported. GEH is a rare disease relating to non-langerhans cell histiocytoses which are based on a benign reactive proliferation of histiocytes with immunophenotype inconsistent with Langerhans cells. As a result of treatment with methotrexate and betamethasone the improvement in skin condition was achieved.
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28
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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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29
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Generalized Eruptive Histiocytosis With Features of Multinucleate Cell Angiohistiocytoma. Am J Dermatopathol 2017; 38:470-2. [PMID: 26322558 DOI: 10.1097/dad.0000000000000402] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Salunke A, Belgaumkar V, Chavan R, Dobariya R. Laryngeal involvement with fatal outcome in progressive nodular histiocytosis: A rare case report. Indian Dermatol Online J 2016; 7:516-519. [PMID: 27990389 PMCID: PMC5134168 DOI: 10.4103/2229-5178.193913] [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] [Indexed: 11/04/2022] Open
Abstract
Progressive nodular histiocytosis (PNH) represents a very rare type of non-Langerhans cell histiocytosis. It is characterized by progressive appearance of papules and nodules without spontaneous resolution. We report a 60-year-old patient with novel clinical features in the form of extensive noduloulcerative lesions, ichthyotic patches, and laryngeal involvement culminating in fatal outcome prior to therapeutic intervention. Although the presenting features were baffling, histopathology and immunohistochemistry clinched the diagnosis of PNH.
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Affiliation(s)
- Aarti Salunke
- Department of Skin and V.D., B. J. Govt. Medical College and Sassoon General Hospital, Pune, India
| | - Vasudha Belgaumkar
- Department of Skin and V.D., B. J. Govt. Medical College and Sassoon General Hospital, Pune, India
| | - Ravindranath Chavan
- Department of Skin and V.D., B. J. Govt. Medical College and Sassoon General Hospital, Pune, India
| | - Rinkesh Dobariya
- Department of Skin and V.D., B. J. Govt. Medical College and Sassoon General Hospital, Pune, India
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31
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González LF, Motta A, Rolón M, Beltrán JA. Tumors on periorbital, axilla, and groin areas. Int J Dermatol 2016; 56:141-144. [PMID: 27653806 DOI: 10.1111/ijd.13414] [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: 04/25/2016] [Revised: 05/10/2016] [Accepted: 06/06/2016] [Indexed: 11/27/2022]
Affiliation(s)
| | - Adriana Motta
- Dermatology Program, El Bosque University, Bogotá, Colombia.,Dermatology Service, Simón Bolívar Hospital, Bogotá, Colombia
| | - Mariam Rolón
- Dermatopathology Service, Simón Bolívar Hospital, Bogotá, Colombia
| | - Julián A Beltrán
- Radiology Service, Colombian National Cancer Institute, Bogotá, Colombia
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Srisuttiyakorn C, Bulloch K, Rodic N, Bosenberg M, Ariyan S, Narayan D, Gould Rothberg BE, Galan A. Intratumoral multinucleated giant cells are not a prognostic pathologic feature in cutaneous melanoma. J Cutan Pathol 2016; 43:821-9. [DOI: 10.1111/cup.12750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/30/2016] [Accepted: 05/30/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Chutika Srisuttiyakorn
- Department of Medicine, Division of DermatologyPhramongkutklao Hospital Bangkok Thailand
- Department of DermatologyYale School of Medicine New Haven CT USA
| | - Kaleigh Bulloch
- Department of Internal Medicine, Medical Oncology DivisionYale School of Medicine New Haven CT USA
| | - Nemanja Rodic
- Department of DermatologyYale School of Medicine New Haven CT USA
| | - Marcus Bosenberg
- Department of DermatologyYale School of Medicine New Haven CT USA
- Department of PathologyYale School of Medicine New Haven CT USA
| | - Stephen Ariyan
- Department of Surgery, Section of Plastic and Reconstructive SurgeryYale School of Medicine New Haven CT USA
| | - Deepak Narayan
- Department of Surgery, Section of Plastic and Reconstructive SurgeryYale School of Medicine New Haven CT USA
| | - Bonnie E. Gould Rothberg
- Department of Internal Medicine, Medical Oncology DivisionYale School of Medicine New Haven CT USA
- Department of PathologyYale School of Medicine New Haven CT USA
- Department of EpidemiologyYale School of Medicine New Haven CT USA
| | - Anjela Galan
- Department of DermatologyYale School of Medicine New Haven CT USA
- Department of PathologyYale School of Medicine New Haven CT USA
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Acral Sclerosing Histiocytic Nodules: A New Entity in Cutaneous Histiocytosis? Am J Dermatopathol 2016; 39:232-233. [PMID: 27097345 DOI: 10.1097/dad.0000000000000602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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34
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Tariq S, Hugenberg ST, Hirano-Ali SA, Tariq H. Multicentric reticulohistiocytosis (MRH): case report with review of literature between 1991 and 2014 with in depth analysis of various treatment regimens and outcomes. SPRINGERPLUS 2016; 5:180. [PMID: 27026876 PMCID: PMC4766148 DOI: 10.1186/s40064-016-1874-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/16/2016] [Indexed: 12/11/2022]
Abstract
Multicentric reticulohistiocytosis is a rare disease affecting skin and joints primarily and rarely other organs. We present a case report of this disease and an extensive review of the literature. We reviewed the data between 1991 and 2014 and extracted 52 individual cases. Only articles in English were chosen after checking for relevance. The articles were studies and data was extracted into excel spread sheets and later used to compute such variables like frequency, mean and percentage of distribution of various clinical manifestations. The treatments used in these articles were critically analyzed and graded for their relative efficacy for skin and joint manifestations. The grades were 0 = worse, 1 = no benefit/condition remained same, 2 = improvement without resolution, and 3 = resolution. This article also reports the demographic, clinical, laboratory and pathological data from the reviewed articles. Authors attempted to discuss the findings of this review in depth to help manage this condition and proposed a treatment algorithm to help clinicians approach this rare and challenging disease.
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Affiliation(s)
- Saad Tariq
- Division of Rheumatology, Department of Medicine, Indiana University School of Medicine, 1120 West Michigan Street, Room CL 370, Indianapolis, IN 46202 USA
| | - Steven T Hugenberg
- Division of Rheumatology, Department of Medicine, Indiana University School of Medicine, 1120 West Michigan Street, Room CL 370, Indianapolis, IN 46202 USA
| | - Stefanie A Hirano-Ali
- Dermatopathology Division, Department of Pathology, Indiana School of Medicine, Indianapolis, IN USA
| | - Hassan Tariq
- Department of Histopathology, AFIP (Armed Forces Institute of Pathology) , Rawalpindi, Pakistan
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35
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Harris AG, Wijayanti A, Llewellyn M, Muhaidat J, Kossard S, Murrell DF. Multiple cutaneous reticulohistiocytomas successfully treated with topical psoralen plus ultraviolet A therapy combined with intralesional injections of triamcinolone acetonide. JAAD Case Rep 2015; 1:157-9. [PMID: 27051716 PMCID: PMC4808701 DOI: 10.1016/j.jdcr.2015.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2022] Open
Affiliation(s)
- Adam G Harris
- Department of Dermatology, St George Hospital, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Asri Wijayanti
- Department of Dermatology, St George Hospital, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | | | | | | | - Dedee F Murrell
- Department of Dermatology, St George Hospital, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
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36
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Ferguson SD, Waguespack SG, Langford LA, Ater JL, McCutcheon IE. Fatal juvenile xanthogranuloma presenting as a sellar lesion: case report and literature review. Childs Nerv Syst 2015; 31:777-84. [PMID: 25503249 DOI: 10.1007/s00381-014-2604-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Juvenile xanthogranuloma (JXG) is a histiocytic condition in the spectrum of non-Langerhans histiocytosis that preferentially affects children. Rarely this condition can involve the central nervous system (CNS) with devastating consequences. METHODS The authors report the unique case of an 11-year-old child who initially presented with a sellar lesion without evidence of the cutaneous stigmata typical of JXG. She was later discovered to have JXG following initial diagnosis of granulomatous hypophysitis, with development of widespread intracranial disease and subsequent neurological deterioration. She underwent subtotal resection of her sellar lesion followed by whole brain radiation and systemic chemotherapy; however, she succumbed to her disseminated disease within 1 month of the JXG diagnosis. CONCLUSIONS This is a rare case of fatal disseminated intracranial JXG without cutaneous manifestations. Additionally, the initial presentation as a sellar lesion is particularly unusual and seldom described in the literature.
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Affiliation(s)
- Sherise D Ferguson
- Department of Neurosurgery, The University of Texas M. D. Anderson Cancer Center, 1400, Holcombe Blvd., Unit 442, Houston, TX, 77030, USA,
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37
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Purohit D, Chanduka AK, Sharma V, Mittal RS, Singhvi S. Juvenile Xanthogranuloma of adult spine: A rare case and review of literature. Asian J Neurosurg 2015; 9:239. [PMID: 25685229 PMCID: PMC4323976 DOI: 10.4103/1793-5482.146640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Juvenile Xanthogranuloma (JXG) is a rare disorder of central nervous system. It rarely produces compressive myelopathy. On reviewing world literature, we could find only nine cases of this disease involving spine and of which only four cases were in adults’ i.e., 18 years and above. We are presenting a case of Spinal JXG in an 18-year-old male with thoracic compressive myelopathy presenting as short duration progressive paraparesis. Magnetic Resonance Imaging of Spine showed mass lesion in epidural space compressing cord from behind without any bony involvement at D7 to D10 vertebral segment. It was isointense on T1 and hyperintense on T2 with no contrast enhancement. D7 to D10 Laminectomy with complete excision of firm epidural mass was carried out. The histopathology with tumor markers confirmed the diagnosis of JXG. Post-operative neurological recovery in this patient was good. His power improved to grade 5/5 with decreased spasticity. Follow-up MRI at 3 months showed no residual tumor. This case appears to be the first in the series with entirely extradural component in adult thoracic spine.
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Affiliation(s)
- Devendra Purohit
- Departments of Neurosurgery, and Pathology, SMS Medical College, Jaipur, Rajasthan, India
| | - Amit Kumar Chanduka
- Departments of Neurosurgery, and Pathology, SMS Medical College, Jaipur, Rajasthan, India
| | - Vinod Sharma
- Departments of Neurosurgery, and Pathology, SMS Medical College, Jaipur, Rajasthan, India
| | - Radhey Shyam Mittal
- Departments of Neurosurgery, and Pathology, SMS Medical College, Jaipur, Rajasthan, India
| | - Shashi Singhvi
- Departments of Neurosurgery, and Pathology, SMS Medical College, Jaipur, Rajasthan, India
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38
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Stinco G, Patriarca M, Di Loreto C, Patrone P. A histiocytic disorder that does not easily fit into the classification of the juvenile xanthogranuloma family. Int J Dermatol 2015; 52:849-55. [PMID: 23789603 DOI: 10.1111/j.1365-4632.2011.05358.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Giuseppe Stinco
- Department of Experimental Medical and Clinical Sciences, DISM, Institute of Dermatology, University of Udine, Udine, Italy.
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39
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Abduljabbar A, Ahsan MK, Buraik MA, Al Attas K, Gamal A, Kumar S. Juvenile xanthogranuloma: Late presentation of giant form ends with atrophic sequelae: Case report. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2015. [DOI: 10.1016/j.jdds.2014.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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40
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Coutinho I, Moreira S, Ramos L, Robalo Cordeiro M, Cardoso J, Gonçalo M, Tellechea O. Plaque-like papular xanthoma: a new variant of non-Langerhans cell disease. J Eur Acad Dermatol Venereol 2014; 30:332-3. [DOI: 10.1111/jdv.12725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- I. Coutinho
- Department of Dermatology; Coimbra University Hospital; Coimbra Portugal
| | - S. Moreira
- Department of Internal Medicine; Coimbra University Hospital; Coimbra Portugal
| | - L. Ramos
- Department of Dermatology; Coimbra University Hospital; Coimbra Portugal
| | - M. Robalo Cordeiro
- Department of Dermatology; Coimbra University Hospital; Coimbra Portugal
| | - J. Cardoso
- Department of Dermatology; Coimbra University Hospital; Coimbra Portugal
| | - M. Gonçalo
- Department of Dermatology; Coimbra University Hospital; Coimbra Portugal
| | - O. Tellechea
- Department of Dermatology; Coimbra University Hospital; Coimbra Portugal
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41
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Patsatsi A, Kyriakou A, Sotiriadis D. Benign cephalic histiocytosis: case report and review of the literature. Pediatr Dermatol 2014; 31:547-50. [PMID: 23551579 DOI: 10.1111/pde.12135] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Benign cephalic histiocytosis (BCH) is a rare type of non-Langerhans histiocytic disorder, usually presenting with small, yellow-red or yellow-brown, asymptomatic papules, located mostly on the head and neck of infants and young children. The histopathologic hallmark of BCH is a well-circumscribed histiocytic infiltrate in the superficial to mid-reticular dermis. BCH is a self-healing disorder, with the eruptions regressing spontaneously in most cases; therefore no treatment is required. We present a case of BCH in a 7-month-old boy who was referred to our department with multiple, asymptomatic, yellow-red papules located on his face, and we review 55 cases published in the English-language literature in an effort to better describe and understand this unusual entity.
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Affiliation(s)
- Aikaterini Patsatsi
- Second Dermatology Department, Aristotle University School of Medicine, Thessaloniki, Greece
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42
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Nakamura Y, Nakamura A, Muto M. Solitary spindle cell xanthogranuloma mimicking a spitz nevus. Am J Dermatopathol 2014; 35:865-7. [PMID: 24257193 DOI: 10.1097/dad.0b013e3182840d2d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Yoshitaka Nakamura
- Department of Dermatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
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43
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KRAUSE MEGANL, LEHMAN JULIAS, WARRINGTON KENNETHJ. Multicentric Reticulohistiocytosis Can Mimic Rheumatoid Arthritis. J Rheumatol 2014; 41:780-1. [DOI: 10.3899/jrheum.131062] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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44
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Nakayashiki N, Akita H, Mori W, Watanabe D, Sakai Y, Yoshimura Y. Effective surgical treatment of progressive nodular histiocytosis. J Plast Surg Hand Surg 2014; 48:80-3. [PMID: 24428162 DOI: 10.3109/2000656x.2012.748323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Progressive nodular histiocytosis (PNH) is a rare benign self-limiting histiocytic disorder of the skin that is characterised by the progressive appearance of widespread xanthomatous lesions with no spontaneous remission. We operated on a 13-year-old girl with PNH four times with a result that had stabilised the condition at 1 year.
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45
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Bakry OA, Samaka RM, Kandil MA, Younes SF. Indeterminate cell histiocytosis with naïve cells. Rare Tumors 2013; 5:e13. [PMID: 23772299 PMCID: PMC3682452 DOI: 10.4081/rt.2013.e13] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 12/19/2012] [Accepted: 01/14/2013] [Indexed: 11/28/2022] Open
Abstract
Histiocytoses are a heterogeneous group of disorders characterized by proliferation and accumulation of cells of mononuclear-macrophage system and dendritic cells. Histiocytoses are categorized according to the cell of origin into Langerhans cell histiocytosis (LCH), Non Langerhans cell histiocytoses and indeterminate cell histiocytosis (ICH). ICH is an extraordinary rare neoplastic dendritic cell disorder that has poorly understood histogenesis and pathogenesis. It is characterized by a proliferation of dendritic cells, which mimic Langerhans cells immunophenotypically (positive for CD1a and S-100 protein), but lack Birbeck granules characteristic of Langerhans cells. Twenty-four year-old Egyptian male was presented with reddish brown chest wall nodule. Clinical, histopathological, immunohistochemical and ultrastructure features are typical for ICH. He was in a good state without any evidence of recurrence or metastasis after 24 months follow up. Peculiar histopathological features were detected in the present case. Many unidentified cells with Hematoxylin & Eosin Langerhans like features showed negative staining for S-100, CD1a, Langerin and CD68. In absence of cellular atypia and mitosis, the infiltrating cells showed epidermotropism that was reported once in ICH as well as neural and perineural invasion that were not previously reported. Therefore we prefer using a tentatively designated diagnosis; dendritic cell tumor, not otherwise specified or newly proposed diagnosis (Indeterminate cell histocytosis with naïve cells) for the present case.
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Affiliation(s)
- Ola A Bakry
- Department of Dermatology, Andrology and STDs
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48
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Trotta F, Colina M. Multicentric reticulohistiocytosis and fibroblastic rheumatism. Best Pract Res Clin Rheumatol 2013; 26:543-57. [PMID: 23040366 DOI: 10.1016/j.berh.2012.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2012] [Indexed: 12/22/2022]
Abstract
Multicentric reticulohistiocytosis (MRH) and fibroblastic rheumatism (FR) are uncommon disorders with similar joint and skin manifestations. They are usually included among the non-Langerhans histiocytoses, but recent insights drive some criticism. The diagnosis is often challenging and must be confirmed by the histological typical features. If the skin manifestations are missing, the arthritic complaints may be confused with those of other rheumatic disorders. In these cases, only a careful clinical and radiological evaluation leads to the correct diagnosis. The natural course of the diseases may rapidly develop into disabling manifestations, making an aggressive treatment strongly recommendable. There is emerging evidence that anti-tumour necrosis factor-α agents and bisphosphonates are promising drugs for MRH, while a course of methotrexate and steroids seems to be the best option for FR. Finally, the clinician should be aware that in many cases MRH, but not FR, is associated with a large number of systemic manifestations and with malignancy. This eventuality must be accurately ruled out.
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Affiliation(s)
- Francesco Trotta
- Section of Rheumatology, Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
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49
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Abstract
Recognition of the different types of multinucleated giant cells in neoplastic and pseudotumoral lesions of the skin may be helpful in the differential diagnosis of these tumors. In this review, we will analyze the different types of multinucleated giant cells that can be found in nonepithelial cutaneous tumors and, more importantly, the clinicopathological context in which they are found. Touton giant cells are typically present in juvenile xanthogranuloma, necrobiotic xanthogranuloma, and some subtypes of xanthomas. Giant cells with a ground glass appearance are typically present in the solitary reticulohistiocytoma and multicentric reticulohistiocytosis. Osteoclast-like cells are found in giant cell tumors (GCT) of soft parts, plexiform fibrohistiocytic tumor, and atypical fibroxanthoma. Floret-like cells are present in giant cell fibroblastoma, pleomorphic lipoma, multinucleate cell angiohistiocytoma, and giant cell collagenoma.
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Les histiocytoses : comment classer ces affections hétérogènes à fort tropisme cutané ? Ann Dermatol Venereol 2013; 140:79-82. [DOI: 10.1016/j.annder.2012.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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