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Fard-Esfahani A, Saidi B, Seyedinia S, Emami-Ardekani A, Eftekhari M. Potential role of 18F-FDG PET/CT in a case of progressive Rosai Dorfman disease. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE & BIOLOGY 2021; 9:62-66. [PMID: 33392352 PMCID: PMC7701221 DOI: 10.22038/aojnmb.2020.51742.1356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/30/2020] [Accepted: 10/21/2020] [Indexed: 01/23/2023]
Abstract
Rosai Dorfman disease is a rare form of nonlangerhans cell histiocytosis, presenting with extensive lymphadenopathies. Treatment in most cases of nodal disease, involves close observation; however, extranodal involvement requires a more definitive treatment strategy. Herein, we report a case of extensive Rosai Dorfman disease in a 43-year-old woman presenting for evaluation of treatment response by 18F-FDG PET/CT after frequent relapses and disease progression. In addition to extensive lymphadenothapies in cervical, supraclavicular, superior mediastinum, axillary, abdominopelvic and inguinofemoral regions, the patient had metabolically active bone and subcutaneous lesions which were not previously recognized. Following this 18F-FDG PET/CT study, the patient management was changed to sirolimus and prednisolone. To choose the best treatment option for Rosai Dorfman patients, knowledge of the full extent of disease is important. Compared with conventional imaging, 18F-FDG PET/CT has the advantage of being a whole-body imaging modality and can recognize disease involvement prior to any anatomical changes.
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Affiliation(s)
| | - Bahare Saidi
- Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Long-Lasting Follow-Up with Low-Dose Steroid in an 18-Year-Old Male with Rosai-Dorfman Disease. Case Rep Med 2020; 2020:5727569. [PMID: 32180809 PMCID: PMC7063216 DOI: 10.1155/2020/5727569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/05/2020] [Indexed: 11/17/2022] Open
Abstract
Rosai–Dorfman disease (RDD) is a rare and benign pathology of sinus histiocytosis of unknown etiology. Lymphadenopathy is the predominant clinical manifestation, but diverse organs can also be affected. Histological features involve S-100+ histiocytes with characteristic nuclear features within the enlarged sinusoids of the lymph nodes. The clinical course is unpredictable, but is often benign with spontaneous resolution of disease in most patients. We report a patient with bilateral massive enlargement of cervical, axillary, and inguinal lymph nodes, moderately enlarged spleen, and a weight loss of 15 kg. Excisional biopsy from the cervical lymph node showed that the dilated sinusoids were infiltrated by lymphocytes, plasma cells, and large histiocytes with CD 68 and S-100 protein positive. Due to the slow progression of the disease, oral prednisolone with a body weight of 1 mg/kg was started in March 2016. The steroid dosage has been adjusted many times during the clinical follow-up. After 33 months, steroid treatment resulted in partial shrinkage of lymph nodes, the spleen returned to its normal size, and the patient gained weight. After 38 months of follow-up, no systemic symptoms, sign, or extranodal involvement were detected, and the patient continued with low-dose steroid treatment.
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Kasonkanji E, Seguin R, Kaimila B, Dhungel BM, Painschab M, Tomoka T, Gopal S. Rosai-Dorfman disease in Malawi. Clin Case Rep 2018; 6:2313-2315. [PMID: 30564319 PMCID: PMC6293177 DOI: 10.1002/ccr3.1820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/17/2018] [Accepted: 08/26/2018] [Indexed: 11/08/2022] Open
Abstract
Rosai-Dorfman Disease (RDD) is a rare lymphoproliferative disease with limited cases reported in sub-Saharan Africa, potentially due to a lack of pathological services throughout the region. RDD diagnosis can be difficult, especially in resource-limited setting, as symptoms can be nearly identical to more common causes of lymphadenopathy.
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Affiliation(s)
| | | | | | | | | | | | - Satish Gopal
- UNC Project‐MalawiLilongweMalawi
- University of North CarolinaChapel HillNorth Carolina
- University of Malawi College of MedicineBlantyreMalawi
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Maia RC, de Meis E, Romano S, Dobbin JA, Klumb CE. Rosai-Dorfman disease: a report of eight cases in a tertiary care center and a review of the literature. ACTA ACUST UNITED AC 2014. [PMID: 25493377 PMCID: PMC4288487 DOI: 10.1590/1414-431x20144110] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Rosai-Dorfman disease (RDD) is a nonmalignant histiocytic disorder of unknown origin
that is extremely rare. By immunohistochemistry, the RDD cells are characteristically
S-100 positive and CD1a negative. Emperipolesis is a common histopathological
finding, although not specific for RDD. Lymph node and cutaneous manifestations are
most frequent, but diverse organs can be affected. The clinical course is
unpredictable regardless of treatment. Here, we present a series of 8 cases
presenting lymph node and/or cutaneous lesions. Lymph node involvement was seen in
diverse regions, including mediastinal and retroperitoneal. The treatment response to
steroids was diversified, and the chemotherapy response was disappointing. Associated
autoimmune diseases (Sjögren syndrome and antiphospholipid syndrome) were observed in
2 patients. Regardless of therapy modality, these patients exhibited a favorable
prognosis in a follow-up duration that ranged from 15 to 80 months.
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Affiliation(s)
- R C Maia
- Programa de Pesquisa em Hemato-Oncologia Molecular, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil
| | - E de Meis
- Divisão Clínica, Hospital do Câncer-I, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil
| | - S Romano
- Divisão de Anatomia Patológica, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil
| | - J A Dobbin
- Serviço de Hematologia, Hospital do Câncer-I, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil
| | - C E Klumb
- Programa de Pesquisa em Hemato-Oncologia Molecular, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil
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Zhang X, Hyjek E, Vardiman J. A subset of Rosai-Dorfman disease exhibits features of IgG4-related disease. Am J Clin Pathol 2013; 139:622-32. [PMID: 23596114 DOI: 10.1309/ajcparc3yq0klioa] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In this study we investigated the distribution of IgG4+ plasma cells and regulatory T (T(REG)) cells, a major regulator of IgG4 production, in nodal and extranodal Rosai-Dorfman disease (RDD). Twenty-six specimens (15 nodal, 11 extranodal) were examined, with reactive lymph nodes and site-matched extranodal specimens as controls. Overall, 84.6% (22/26) of the specimens showed various degrees of sclerosis (7 mild, 8 moderate, and 7 severe). Nineteen cases (73.1%) exhibited more than 10 IgG4+ cells/0.060 mm(2) (photographed area at ×40), and 8 cases (30.8%) showed more than 40% of IgG+ cells being IgG4+. Only 1 control case exhibited more than 10 IgG4+ cells/0.060 mm(2) (P < .05). The number of T(REG) cells was comparable between nodal RDD and controls, whereas extranodal RDD exhibited significantly higher numbers of T(REG) cells than controls. These findings demonstrate that a subset of RDD shows features of IgG4-related disease and indicate an overlap between certain aspects of the 2 diseases.
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Affiliation(s)
- Xuefeng Zhang
- Department of Pathology, University of Chicago Medical Center, Chicago, IL
| | - Elizabeth Hyjek
- Department of Pathology, University of Chicago Medical Center, Chicago, IL
| | - James Vardiman
- Department of Pathology, University of Chicago Medical Center, Chicago, IL
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El-Kersh K, Perez RL, Guardiola J. Pulmonary IgG4+ Rosai-Dorfman disease. BMJ Case Rep 2013; 2013:bcr-2012-008324. [PMID: 23580672 DOI: 10.1136/bcr-2012-008324] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare non-malignant proliferation of histiocytes of unknown aetiology that mainly affects lymph nodes. Here we report a case of RDD that presented a diagnostic dilemma due to its atypical presentation and the overlap with IgG4 disease. Our case presented with interstitial lung involvement without lymphadenopathy. Open lung biopsy suggested the diagnosis of RDD. However, the predominant IgG4 positive plasma cells together with the absence of lymphadenopathy were not typical of RDD. Within 1 year, the patient developed diffuse lymphadenopathy and immunohistochemical staining of lymph node aspirates confirmed the diagnosis. Despite trials of corticosteroid therapy, the disease progressed.
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Affiliation(s)
- Karim El-Kersh
- Department of Pulmonary, Critical Care & Sleep Medicine, University of Louisville, Pulmonary, Louisville, Kentucky, USA.
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O' Reilly P, Patel V, Luthert P, Chandrasekharan L, Malhotra R. Orbital Rosai-Dorfman disease with subperiosteal bone involvement mimicking eosinophilic granuloma. Orbit 2012; 31:24-26. [PMID: 22085401 DOI: 10.3109/01676830.2011.631723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The presentation of RDD as an anterior subperiosteal orbital mass with bone involvement has, to the authors' knowledge, not been previously reported. We describe a case of Rosai-Dorfman disease (RDD) presenting as an anterior superolateral subperiosteal orbital mass with erosion of overlying bone mimicking eosinophilic granuloma. It was debulked using endoscopic-guided curettage and the patient was given both local and systemic corticosteroids. Careful histological analysis revealed the diagnosis of RDD and the patient remains asymptomatic and recurrence free at 16 months follow-up. Involvement of the pituitary gland, a recognized yet unusual finding in this condition was also noted. RDD should be considered in the differential diagnosis of a soft tissue mass of the superolateral orbit.
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Affiliation(s)
- Philip O' Reilly
- Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, West Sussex, UK.
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Ide M, Asao T, Yoshida T, Hirato J, Shimura T, Morinaga N, Shitara Y, Ishizaki M, Kuwano H. Rosai-Dorfman disease of the colon presented as small solitary polypoid lesion. Rare Tumors 2010; 2:e2. [PMID: 21139947 PMCID: PMC2994489 DOI: 10.4081/rt.2010.e2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Revised: 12/16/2009] [Accepted: 12/18/2009] [Indexed: 11/23/2022] Open
Abstract
Rosai-Dorfman disease (RDD) was formerly known as "sinus histiocytosis with massive lymphadenopathy", and cases involving the gastrointestinal tract are rare. We present a case of pure extranodal RDD, resected as a polypoid lesion in colonoscopic study. The patient was a 62-year old woman with a history of sigmoidectomy for unexplained peritonitis. Microscopic study of the polypoid lesion showed the submucosal mass with histological and immunological features of RDD. The whole body computed tomography revealed neither lymphadenopathy nor tumor-like mass.
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OKA M, KAMO T, GOTO N, NAGANO T, HIRAYAMA Y, NIBU KI, NISHIGORI C. Successful treatment of Rosai-Dorfman disease with low-dose oral corticosteroid. J Dermatol 2009; 36:237-40. [DOI: 10.1111/j.1346-8138.2009.00630.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chow CP, Ho HK, Chan GCF, Cheung AN, Ha SY. Congenital Rosai-Dorfman disease presenting with anemia, thrombocytopenia, and hepatomegaly. Pediatr Blood Cancer 2009; 52:415-7. [PMID: 19061211 DOI: 10.1002/pbc.21880] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Rosai-Dorfman disease (RDD) is a rare entity of non-Langerhans cell histiocytoses (non-LCH) which usually presents with bilateral painless cervical lymphadenopathy. We describe a neonate with RDD who presented with anemia, thrombocytopenia and hepatomegaly. He recovered spontaneously with conservative management. This represents an atypical presentation of RDD. Conservative management with close monitoring can be adopted for some with systemic involvement.
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Affiliation(s)
- C P Chow
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong, China
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Konca C, Özkurt ZN, Deger M, Akı Z, Yağcı M. Extranodal multifocal Rosai-Dorfman disease: response to 2-chlorodeoxyadenosine treatment. Int J Hematol 2008; 89:58-62. [PMID: 19020950 DOI: 10.1007/s12185-008-0192-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Revised: 09/22/2008] [Accepted: 10/07/2008] [Indexed: 10/21/2022]
Abstract
Rosai-Dorfman disease (RDD) or "sinus histiocytosis with massive lymphadenopathy" is a rare lymphoproliferative disorder of unknown etiology. The disease usually presents with painless lymphadenopathy with occasional extranodal involvement in various organs. We report a case of a 36-year-old man with a history of non-Hodgkin lymphoma (NHL), who recently presented with inguinal lymphadenopathy. Following the diagnosis of RDD on lymph node biopsy, he developed symptoms of spinal cord compression due to a mass lesion discovered at T6-7 vertebral level. 18F-Fluorodeoxyglucose (18FDG) positron emission tomography (PET-CT) revealed extensive disease with lung, renal and bone involvement. The patient received a short course of steroid therapy for cord compression findings and 2-chlorodeoxyadenosine (2-CdA) treatment was initiated for long-term disease control. He had a dramatic sustained response to treatment with six courses of 2-CdA. These results suggest that 2-CdA can be an effective treatment of choice and positron emission tomography with 18FDG can be used for determining the extent of disease and for follow-up in RDD.
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Affiliation(s)
- Ceyla Konca
- Internal Medicine Department, Faculty of Medicine, Gazi University, 40, Sok. 7/7 Burcak Apt., Bahcelievler, 06500, Ankara, Turkey.
| | - Zübeyde N Özkurt
- Division of Hematology, Internal Medicine Department, Faculty of Medicine, Gazi University, 40, Sok. 7/7 Burcak Apt., Bahcelievler, 06500, Ankara, Turkey
| | - Müge Deger
- Internal Medicine Department, Faculty of Medicine, Gazi University, 40, Sok. 7/7 Burcak Apt., Bahcelievler, 06500, Ankara, Turkey
| | - Zeynep Akı
- Division of Hematology, Internal Medicine Department, Faculty of Medicine, Gazi University, 40, Sok. 7/7 Burcak Apt., Bahcelievler, 06500, Ankara, Turkey
| | - Münci Yağcı
- Division of Hematology, Internal Medicine Department, Faculty of Medicine, Gazi University, 40, Sok. 7/7 Burcak Apt., Bahcelievler, 06500, Ankara, Turkey
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Prabhakaran VC, Bhatnagar A, Sandilla J, Olver J, Leibovitch I, Ghabrial R, Goldberg RA, Selva D. Orbital and adnexal Rosai-Dorfman disease. Orbit 2008; 27:356-362. [PMID: 18836933 DOI: 10.1080/01676830802345083] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE To report the clinico-radiological findings, clinical course, and treatment outcomes in five patients with orbital and adnexal Rosai-Dorfman (R-D) disease. METHODS Analysis of case records of patients with Rosai-Dorfman disease seen at four orbital units between January 2000 and December 2006. RESULTS Five patients (3 Caucasian males, 1 Hispanic female, and 1 African female), mean age 41.1 years, (range 18 months to 75 years) with orbital or adnexal Rosai-Dorfman disease were seen during the study period. Four of the patients had orbital involvement and one had eyelid involvement. Presenting features were proptosis (4 patients), diplopia (1 patient), epiphora (1 patient), and eyelid thickening (1 patient). Three of the patients with orbital involvement also had adjacent paranasal sinus involvement, and the nasolacrimal duct was involved in one patient. The patient with eyelid involvement had evidence of cutaneous R-D disease elsewhere in the body. The follow-up period (since initial diagnosis of R-D disease) ranged from 1 month to 15 years, and 2 of the patients had a history of recurrent growth despite treatment. Surgical debulking was employed in 2 patients with good results. CONCLUSIONS Orbital and adnexal Rosai-Dorfman disease is a condition with protean manifestations that may show indolent but unremitting growth despite treatment. The disease may remain extranodal and localized for many years. Adjacent paranasal sinus involvement is commonly seen in conjunction with orbital disease, simulating midline destructive lesions. Surgical debulking gives good results in patients with functional or significant cosmetic problems.
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Affiliation(s)
- Venkatesh C Prabhakaran
- South Australian Institute of Ophthalmology and Department of Ophthalmology and Visual Sciences, University of Adelaide, South Australia.
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