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Al-Hashemi RW, Aldarraji SS, Abdalla T, Hasnah S, Abu-Dayeh A, Telfah HK. The Lone Lump: Cutaneous Rosai-Dorfman Disease as an Isolated Upper Arm Lesion. Cureus 2024; 16:e63542. [PMID: 39086775 PMCID: PMC11289357 DOI: 10.7759/cureus.63542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2024] [Indexed: 08/02/2024] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare disorder characterized by excessive growth of histiocytes. We present a case of a 14-year-old female with cutaneous RDD who had a subcutaneous lump on her left arm for three years. The lump became tender and progressively larger over the past year. She had no systemic symptoms, and her physical examination revealed a mobile, tender lump. Laboratory tests were normal. Surgical excision of the lump was performed, and histopathological examination confirmed RDD with the presence of epithelioid histiocytes with eosinophilic and clear cytoplasm, along with emperipolesis and positive staining for CD68, CD163, S100, and OCT2. The patient was referred for follow-up and required no further treatment. RDD can present with subcutaneous masses without systemic symptoms, and it is important to consider RDD in the differential diagnosis of such cases. Surgical excision is the main treatment, and long-term monitoring is necessary due to the potential for disease recurrence. Awareness of cutaneous RDD presentations is crucial for accurate diagnosis and management.
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Affiliation(s)
| | | | - Tasnim Abdalla
- Family Medicine Residency Program, Medical Education, Hamad Medical Corporation, Doha, QAT
| | - Sham Hasnah
- Family Medicine Residency Program, Medical Education, Hamad Medical Corporation, Doha, QAT
| | - Ala Abu-Dayeh
- Pathology and Laboratory Medicine, Hamad Medical Corporation, Doha, QAT
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NRAS Mutations May Be Involved in the Pathogenesis of Cutaneous Rosai Dorfman Disease: A Pilot Study. BIOLOGY 2021; 10:biology10050396. [PMID: 34063325 PMCID: PMC8147632 DOI: 10.3390/biology10050396] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023]
Abstract
Background: Purely cutaneous Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disorder limited to the skin. To date, its pathogenesis remains unclear. Owing to recent findings of specific mutations in the mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) pathway in histiocytic proliferative disorders, it provides a novel perspective on the pathomechanism of cutaneous RDD. We aim to investigate the genomic mutations in MAPK/ERK pathway in cutaneous RDD. Methods: We retrospectively recruited all cases of cutaneous RDD from two hospitals in Taiwan from January 2010 to March 2020 with the clinicopathologic features, immunohistochemistry, and treatment. Mutations of neuroblastoma RAS viral oncogene homolog (NRAS), Kirsten rat sarcoma 2 viral oncogene homolog (KRAS), and v-raf murine sarcoma viral oncogene homolog B1 (BRAF) in MAPK/ERK pathway were investigated by the highly sensitive polymerase chain reaction with Sanger sequencing. Results: Seven patients with cutaneous RDD were recruited with nine biopsy specimens. The median age was 46 years (range: 17–62 years). Four of seven patients (57.1%) received tumor excision, while the other three chose oral and/or topical or intralesional steroids. NRAS mutation was detected in 4 of 7 cases (4/7; 51.7%), and NRAS A146T was the most common mutant point (n = 4/7), followed by NRAS G13S (n = 2/7). There is no KRAS or BRAF mutation detected. Conclusions: We report the NRAS mutation is common in cutaneous RDD, and NRAS A146T was the most frequent mutation in this cohort. Mutations in the NRAS gene can activate the RAS/MAPK signaling and have been reported to be associated with various cancers. It indicates that NRAS mutation in MAPK/ERK pathway may involve the pathogenesis of cutaneous RDD.
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Yang Z, Yu WT, Liu ZH, Bian K, Xu FM, Shen H. Dermoscopy and reflectance confocal microscopy for the diagnosis of generalized pure cutaneous Rosai-Dorfman disease. Skin Res Technol 2020; 27:288-290. [PMID: 32812293 DOI: 10.1111/srt.12937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/09/2020] [Accepted: 06/25/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Zhen Yang
- Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Wan-Ting Yu
- Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Ze-Hu Liu
- Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Ke Bian
- Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Fa-Ming Xu
- Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Hong Shen
- Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
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Rosai-Dorfman disease as a rare cause of cervical lymphadenopathy - case report and literature review. Cent Eur J Immunol 2018; 43:341-345. [PMID: 30588179 PMCID: PMC6305605 DOI: 10.5114/ceji.2018.80055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/22/2017] [Indexed: 11/17/2022] Open
Abstract
Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare, benign clinical entity of unknown cause. RDD is characterised by the overproduction and accumulation of histiocytes, primarily in the lymph nodes, although it may affect every organ and system. It predominantly affects children and young adults. Typically, patients are in good general condition, with massive cervical lymphadenopathy and fever. In about 40% of cases extranodal localisation of RDD is diagnosed. In laboratory tests the most common abnormalities are increased erythrocyte sedimentation rate (ESR), leukocytosis with neutrophilia, normocytic anaemia, and hypergammaglobulinaemia. Histopathological examination remains the mainstay of diagnosis - lymph nodes have massive sinusoidal dilation, containing histiocytes positive for S-100 and CD68, and negative for CD1a. Most patients do not require treatment as spontaneous remissions are observed. We present a brief review of the literature and the case of a six-year-old boy with cervical lymphadenopathy diagnosed with RDD. So far, the patient has not required systemic treatment and has been kept under observation.
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Karadag AS, Tekin B, Hurdogan O, Dagdelen D, Dogan O, Buyukbabani N. A case report demonstrating potential utility of topical imiquimod for cutaneous Rosai-Dorfman disease. Dermatol Ther 2018; 32:e12759. [PMID: 30288863 DOI: 10.1111/dth.12759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/25/2018] [Accepted: 09/29/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Ayse S Karadag
- Department of Dermatology, Istanbul Medeniyet University, Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Burak Tekin
- Department of Dermatology, Istanbul Medeniyet University, Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Ozge Hurdogan
- Pathology Department, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Deniz Dagdelen
- Department of Dermatology, Istanbul Medeniyet University, Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Oner Dogan
- Pathology Department, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Nesimi Buyukbabani
- Pathology Department, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
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Geller S, Busam K, Hamlin PA, Moskowitz AJ, Horwitz SM, Myskowski PL. Treatment of Rosai-Dorfman disease with oral bexarotene: a case series. J DERMATOL TREAT 2018; 30:503-505. [PMID: 30244619 DOI: 10.1080/09546634.2018.1528001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disorder of unknown etiology. The skin is the most frequent extranodal site of RDD involvement and may be the only organ involved. While RDD is an indolent self-limited disease, treatment is needed in patients with extensive, persistent or progressive disease, or if cosmetic disfigurement or physical impairment significantly affects the patient. There is no specific treatment for RDD, and multiple therapeutic approaches have been described with variable success rates. Ojective: To demonstrate the clinical efficacy of oral bexarotene for RDD. Materials and methods: Descriptive retrospective case series of three patients with RDD receiving oral bexarotene. Results: Two patients had excellent response and regression of their skin lesions was achieved with long-term therapy. In the other patient, pruritus was promptly controlled while the lesions did not seem to regress and treatment was discontinued after five months. Conclusions: Our case series is the first report in the literature of the use of oral bexarotene as an effective and safe treatment for RDD.
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Affiliation(s)
- Shamir Geller
- a Dermatology Service, Department of Medicine , Memorial Sloan Kettering Cancer Center, and Weill Cornell Medicine , New York , NY , USA
| | - Klaus Busam
- b Department of Pathology , Memorial Sloan Kettering Cancer Center, and Weill Cornell Medicine , New York , NY , USA
| | - Paul A Hamlin
- c Lymphoma Service, Department of Medicine , Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine , New York , NY , USA
| | - Alison J Moskowitz
- c Lymphoma Service, Department of Medicine , Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine , New York , NY , USA
| | - Steven M Horwitz
- c Lymphoma Service, Department of Medicine , Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine , New York , NY , USA
| | - Patricia L Myskowski
- a Dermatology Service, Department of Medicine , Memorial Sloan Kettering Cancer Center, and Weill Cornell Medicine , New York , NY , USA
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Gupta A, Arora P, Batrani M, Sharma PK. Multifocal cutaneous Rosai-Dorfman disease masquerading as lupus vulgaris in a child. An Bras Dermatol 2018; 93:766-768. [PMID: 30156639 PMCID: PMC6106673 DOI: 10.1590/abd1806-4841.20187796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 02/16/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Aastha Gupta
- Department of Dermatology, Dr Ram Manohar Lohia Hospital, New Delhi,
India
| | - Pooja Arora
- Department of Dermatology, Dr Ram Manohar Lohia Hospital, New Delhi,
India
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Kinio AE, Sawchuk MA, Pratt M. Atypical Primary Cutaneous Rosai Dorfman Disease: A Case Report. J Cutan Med Surg 2017. [DOI: 10.1177/1203475417713489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Rosai Dorfman disease (RDD) is a rare disorder that typically presents with bilateral cervical lymphadenopathy and follows a benign course. Objective: We present a case of late-onset atypical primary cutaneous RDD that is resistant to treatment modalities described in the literature. Methods: Case report. Results: An 84-year-old woman presented with a 7-year history of cutaneous lesions histologically consistent with RDD. She later failed initial treatments of acitretin and thalidomide. Conclusion: Physicians must be aware of unusual presentations of RDD. Also, further treatment options must be explored for patients resistant to classical management of RDD.
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Affiliation(s)
- Anna E. Kinio
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Melanie Pratt
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
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Al-Khateeb THH. Cutaneous Rosai-Dorfman Disease of the Face: A Comprehensive Literature Review and Case Report. J Oral Maxillofac Surg 2015; 74:528-40. [PMID: 26455470 DOI: 10.1016/j.joms.2015.09.017] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 09/08/2015] [Accepted: 09/14/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE Cutaneous Rosai-Dorfman disease (C-RDD) is a rare, benign, non-Langerhans cell histiocytosis that can affect any skin area. The purpose of this study was to characterize C-RDD of the face through a literature review of published case reports of this lesion and present a new case of C-RDD. MATERIALS AND METHODS An English-language search of 3 databases (PubMed, Scopus, and EBSCO Search) was conducted for cases of C-RDD of any skin area that had been published since 1969. Repeated citations of the same article in more than 1 database were deleted. Cases of C-RDD with solely facial involvement or involving the face and other skin parts were included and analyzed. Details of C-RDD cases (demographic features, regional distribution, clinical presentation, treatment, and follow-up course) were methodically reviewed and collected in Excel spreadsheets. Simple statistical analyses were conducted using Excel. RESULTS The literature search yielded 578 published cases of C-RDD affecting any skin area; of these, 65 cases (11.2%) had facial skin involvement. The male-to-female ratio was 1:1.5, and the average age at presentation was 43.5 years (standard deviation, 12.4 yr). The racial distribution of facial C-RDD was, in descending order, 74.5% in Asians, 20% in Caucasians, and 5.5% in blacks. The most commonly affected facial skin regions were the cheeks and periorbital area, and most lesions were multiple in number and bilaterally distributed. The vast majority of facial C-RDD lesions presented as asymptomatic, nonulcerative, red, nodular plaques with durations ranging from 1 month to a few years. Many methods have been attempted for the treatment of facial C-RDD. However, the combined cure rate for all published treatment methods was only 28.6%. Surgical excision was the most effective treatment method, and corticosteroids were the least effective. CONCLUSION This article has tried to characterize facial C-RDD lesions for easier management by maxillofacial surgeons.
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Affiliation(s)
- Taiseer Hussain Hassan Al-Khateeb
- Professor and Consultant, Department of Oral and Maxillofacial Surgery, Jordan University of Science and Technology, Irbid, Jordan; Visiting Professor and Consultant, Department of Oral and Maxillofacial Surgery, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
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Rosai-Dorfman disease: a case report with nodal and cutaneous involvement and review of the literature. Am J Dermatopathol 2014; 36:353-7. [PMID: 23863552 DOI: 10.1097/dad.0b013e31829e5564] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy, is a benign proliferative disorder of histiocytes with an unknown etiology. It is a rare disease characterized by overproduction and accumulation of histiocytes within lymph node sinuses and many other extranodal sites, including skin, oral and nasal cavities, respiratory tract, eyelid, and periorbital area. In this case, a 44-year-old woman with diagnosis of Rosai-Dorfman disease, with xanthelasma-like cutaneous lesions on facial area, extending to her neck and acneiform papules on her back, cervical lymph node involvement, and concomitant presence of diabetes insipidus was presented. Histopathological examination of the lesions demonstrated diffuse lymphocyte, plasmocyte, eosinophil, and sparse neutrophil infiltration, together with histiocytes showing phagocytosed inflammatory cells (emperipolesis). Histiocytes demonstrated immunoreactivity with the antibodies for CD68 and S100, whereas they were negative for CD1a and Langerin. Laboratory tests were normal, except mild immunoglobulin G hypergammaglobulinemia. Systemic methylprednisolone therapy was effective for cutaneous lesions.
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Farooq U, Chacon AH, Vincek V, Elgart GW. Purely cutaneous rosai-dorfman disease with immunohistochemistry. Indian J Dermatol 2013; 58:447-50. [PMID: 24249896 PMCID: PMC3827516 DOI: 10.4103/0019-5154.119953] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: The cutaneous form of Rosai-Dorfman disease (RDD) is a rare entity that manifests solely with skin papules or nodules and does not present with the usual myriad of symptoms of classical RDD. Aims: To analyze the most recent publications regarding cutaneous RDD to point out updated, relevant aspects regarding future directions for clinical recognition and management. To identify histopathologic and immunohistochemical findings in skin lesions that permit diagnosis. Materials and Methods: We present a case of a gentleman with a history of multiple lipomas with a new solitary nodule on physical exam; microscopic examination shows the typical findings of RDD with the associated diagnostic immunohistochemical profile, as well as the expected finding of histiocytes engulfing other intact inflammatory cells. Results: Our patient was managed with surgical excision of the entire lesion, one of the several available treatment options. Long-term follow-up 2 years later did not reveal any complications, recurrences, or new lesions. Conclusion: The diagnosis of cutaneous RDD is differentiated from other histiocytic conditions by the combination of clinical findings accompanied by histopathologic and immunohistochemical confirmation.
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Affiliation(s)
- Uzma Farooq
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
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Vuong V, Moulonguet I, Cordoliani F, Crickx B, Bezier M, Vignon-Pennamen MD, Flageul B, Bagot M, Petit A. [Cutaneous revelation of Rosai-Dorfman disease: 7 cases]. Ann Dermatol Venereol 2012; 140:83-90. [PMID: 23395488 DOI: 10.1016/j.annder.2012.06.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Revised: 05/14/2012] [Accepted: 06/28/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rosai-Dorfman disease (RDD) is a benign form of non-Langerhans-cell histiocytosis. It is identified by a particular histological profile first observed in febrile lymph nodes. Extranodal sites are frequent. The most common site is the skin, which can reveal the disease despite a difficult and delayed diagnosis. Seven cases of cutaneous revelation of RDD were studied retrospectively in order to delineate the clinical characteristics and facilitate diagnosis and treatment of this extremely rare disease. PATIENTS AND METHODS Six cases of RDD from 1990 to 2011 were identified in the photographic and histopathological records of the Saint-Louis Hospital and one case came from a Bichat Hospital consultation. The diagnosis was based in all cases on histopathology results. RESULTS Patients consisted of four men and three women aged between 31 and 69 years. Cutaneous lesions (3 to 20) revealed the disease in all of them and the time from disease onset to diagnosis ranged from six months to five years. The clinical presentation was erythematous or orange popular nodules or plaques, usually on the face. Microscopically, a dense dermal infiltration was observed, in some cases extending into the subcutaneous tissue, with pale histiocytic cells characterised by emperipolesis, plasma cells, lymphocytes, some neutrophils and variable fibrosis. The diagnosis, initially erroneous in 4 cases, was rectified by a second reading of histopathology slides, and immunohistochemical studies showed expression of S-100 protein in histiocytes but not CD1a. Three patients had pure cutaneous RDD. Two neurological sites and one nasal site were also found, with one ENT site and sequelae of previous uveitis in one patient. All extra-cutaneous sites were identified by clinical examination. Different treatments were proposed according to the sites and impact of the disease. In one case, the lesions regressed spontaneously after 18 months. COMMENTS Few RDD series have been published and they mainly concern Asian patients. The ethnic origin of our patients was varied. The main findings were: 1) common clinical findings (orange or erythematous papules or nodules, mostly on the upper body), which should alert the dermatologist and histopathologist to the possible diagnosis of RRD; 2) the possibility, already mentioned in the literature, of spontaneous regression and a good prognosis; 3) the need for thorough evaluation by thoracic, abdominal and cerebral CT (computed tomography) or more a PET (positron emission tomography) scan to screen for potentially dangerous visceral sites, and also clinical follow up.
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Affiliation(s)
- V Vuong
- Service de dermatologie, hôpital Saint-Louis, GHU Paris Nord, AP-HP, Paris, France
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Landim FM, Rios HDO, Costa CO, Feitosa RGF, Rocha Filho FD, Costa AAA. Cutaneous Rosai-Dorfman disease. An Bras Dermatol 2010; 84:275-8. [PMID: 19668942 DOI: 10.1590/s0365-05962009000300010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Accepted: 01/26/2009] [Indexed: 12/13/2022] Open
Abstract
Rosai-Dorfman disease is a self-limited benign disease. Rosai and Dorfman first described it in 1969, and the etiology of the disease remains unknown. Main manifestations are cervical adenopathy associated with fever, leukocytosis with neutrophilia and polyclonal gamaglobulinemia. Although the skin is the most common site of extra nodal disease, Rosai-Dorfman disease restricted to the skin is very rare with only a few cases described in the literature. This paper reports a rare case of cutaneous Rosai-Dorfman with skin as the sole site, and reviews the controversies of diagnosis and treatment.
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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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