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Buján MM, Sánchez La Rosa C, Galluzzo Mutti ML, Braier J, Diamond EL. Progressive nodular histiocytosis in a 9-year-old boy treated with cobimetinib. Pediatr Dermatol 2022; 39:115-118. [PMID: 34935192 PMCID: PMC8819602 DOI: 10.1111/pde.14887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Progressive nodular histiocytosis is a rare variant of non-Langerhans cell histiocytosis that affects the skin and mucous membranes and displays a progressive clinical course and poor response to treatment. We describe a case of severe progressive nodular histiocytosis harboring a KRAS p.G12S mutation in a 9-year-old boy, refractory to chemotherapy, who was successfully treated with the MEK inhibitor cobimetinib. This is the first report of the use of MEK inhibition for this histiocytosis subtype in a pediatric patient.
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Affiliation(s)
- María Marta Buján
- Department of Dermatology, Hospital Nacional de Pediatría "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
| | - Cristian Sánchez La Rosa
- Department of Hemato-Oncology, Hospital Nacional de Pediatría "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
| | - María Laura Galluzzo Mutti
- Department of Pathology, Hospital Nacional de Pediatría "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
| | - Jorge Braier
- Department of Hemato-Oncology, Hospital Nacional de Pediatría "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
| | - Eli L Diamond
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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2
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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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3
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Sampedro-Ruiz R, Martos-Cabrera L, Fraga-Fernández J, Aragüés M, Chicharro P. Multiple adult xanthogranuloma with upper airway involvement. Int J Dermatol 2021; 60:e317-e319. [PMID: 33560521 DOI: 10.1111/ijd.15453] [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: 10/31/2020] [Revised: 12/23/2020] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Maximiliano Aragüés
- Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Pablo Chicharro
- Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain
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4
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Chan WH, Shah A, Bae G, Hambro C, Martin BA, Brown R, Novoa R, Kwong BY. Disseminated non-Langerhans cell histiocytosis with an IRF2BP2-NTRK1 gene fusion identified by next-generation sequencing. JAAD Case Rep 2020; 6:1156-1158. [PMID: 33134460 PMCID: PMC7591321 DOI: 10.1016/j.jdcr.2020.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Warren H. Chan
- Department of Dermatology, Stanford University, Stanford, California
| | - Aatman Shah
- Department of Dermatology, Stanford University, Stanford, California
| | - Gordon Bae
- Department of Dermatology, Stanford University, Stanford, California
| | - Caely Hambro
- Department of Dermatology, Stanford University, Stanford, California
| | - Beth A. Martin
- Department of Hematology, Stanford University, Stanford, California
| | - Ryanne Brown
- Department of Dermatology, Stanford University, Stanford, California
- Department of Pathology, Stanford University, Stanford, California
| | - Roberto Novoa
- Department of Dermatology, Stanford University, Stanford, California
- Department of Pathology, Stanford University, Stanford, California
| | - Bernice Y. Kwong
- Department of Dermatology, Stanford University, Stanford, California
- Correspondence to: Bernice Y. Kwong, MD, 780 Welch Road, Palo Alto, CA 94304.
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5
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Chen Q, Lee JSS, Liang MW, Chan MMF, Pujol RM, Requena L, Tan SH. Indeterminate cell histiocytosis in a Chinese patient with progressive and extensive nodular lesions and mixed indeterminate cell and macrophage-monocyte lineage. J Cutan Pathol 2018; 45:428-433. [PMID: 29469188 DOI: 10.1111/cup.13132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 02/12/2018] [Accepted: 02/16/2018] [Indexed: 11/30/2022]
Abstract
Indeterminate cell histiocytosis (ICH) is an extremely rare cutaneous neoplastic disorder. It has the immunophenotypic features of both Langerhans and non-Langerhans cell histiocytosis. We report here a case of a healthy young Chinese woman who presented with disfiguring, thick, infiltrated cutaneous nodules on the face, trunk and extremities which appeared progressively over a period of 4 years. No systemic involvement has been detected so far. Results of a skin biopsy showed diffuse dermal infiltration of histiocytoid cells with indented nuclei and positive staining for S100 and CD1a and negativity for CD207 (langerin). Admixed within were some CD68-positive foamy histiocytes and multinucleated giant cells with focal expression of CD163. Although the clinical presentation is more typical of progressive nodular histiocytosis, the histology and immunoprofile is consistent with ICH. Our report adds to the limited case reports in the current literature of ICH in the Chinese population.
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Affiliation(s)
- Qiping Chen
- Department of Dermatology, National Skin Centre, Singapore
| | - Joyce S-S Lee
- Department of Dermatology, National Skin Centre, Singapore
| | | | - Michelle M F Chan
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Ramón M Pujol
- Department of Dermatology, Hospital del Mar. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Suat Hoon Tan
- Department of Dermatology, National Skin Centre, Singapore
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6
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Guidolin L, Noguera-Morel L, Hernández-Martín A, Fernández-Llaca H, Rodríguez-Peralto JL, Torrelo A. A Case with Juvenile Xanthogranuloma and Progressive Nodular Histiocytosis Overlap. Pediatr Dermatol 2017; 34:e102-e103. [PMID: 28297144 DOI: 10.1111/pde.13073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A patient with overlap between juvenile xanthogranuloma and progressive nodular histiocytosis is presented. He had progressive, superficial, small, yellow-reddish papules and large dermal nodules, consistent with progressive nodular histiocytosis. Histopathology showed distinctive features of juvenile xanthogranuloma. Our patient reinforces the view that progressive nodular histiocytosis is not a distinct clinical entity, but an evolutionary form of juvenile xanthogranuloma.
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Affiliation(s)
- Lucia Guidolin
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Lucero Noguera-Morel
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | - Héctor Fernández-Llaca
- Department of Dermatology, Hospital Universitario Marques de Valdecilla, Santander, Spain
| | | | - Antonio Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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7
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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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8
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Williams A, Thomas AG, Kwatra KS, Jain K. Progressive Nodular Histiocytosis Associated with Eale's Disease. Indian J Dermatol 2015; 60:388-90. [PMID: 26288410 PMCID: PMC4533540 DOI: 10.4103/0019-5154.160492] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Progressive nodular histiocytosis (PNH) is a rare normolipemic macrophage disorder and belongs to a subgroup of non-Langerhans cell histiocytosis (LCHs) which is characterized by a progressive course with no sign of spontaneous resolution but without systemic involvement. We report a 30-year-old gentleman who presented with skin lesions all over the body associated with gradual bilateral painless loss of vision. On examination, approximately 30 to 40, skin-colored, firm, non-tender papules and nodules were noted over the body especially on the face and trunk. A skin biopsy revealed a cellular tumor in the dermis composed of oval to spindle-shaped cells, positive for CD68 but negative for S-100, CD34, CD21, CD35 and HMB45, supporting a diagnosis of spindle cell histiocytic tumor. Ophthalmic examination revealed a generalized arteriolar attenuation in both eyes. He received Tab Imatinib 400 mg OD for 5 months followed by Tab Pazopanib 800 mg OD for 4 months and both the drugs were stopped due to lack of any response in the skin lesions. We report this case due to its rarity, characteristic clinical presentation, and its association with Eale's disease. Primary treatment remains surgical excision of bothersome lesions and optimal systemic treatment is still unknown.
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Affiliation(s)
- Abhilasha Williams
- Department of Dermatology, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - Abraham G Thomas
- Department of Plastic Surgery, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | | | - Kunal Jain
- Department of Medical Oncology Unit, Christian Medical College and Hospital, Ludhiana, Punjab, India
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9
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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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10
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Hilker O, Kovneristy A, Varga R, Neubert T, Wesselmann U, Flaig MJ, Ruzicka T, Burgdorf W, Lehmann P. Progressive nodular histiocytosis. J Dtsch Dermatol Ges 2012; 11:301-7. [DOI: 10.1111/j.1610-0387.2012.08069.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 10/15/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Olaf Hilker
- Helios Klinikum Wuppertal, Department of Dermatology; Allergology, and Surgical Dermatology; Wuppertal; Germany
| | - Alexander Kovneristy
- Clinic and Polyclinic for Dermatology and Allergology; University of Munich; Germany
| | - Rita Varga
- Clinic and Polyclinic for Dermatology and Allergology; University of Munich; Germany
| | - Thorsten Neubert
- Helios Klinikum Wuppertal, Department of Dermatology; Allergology, and Surgical Dermatology; Wuppertal; Germany
| | - Ulrich Wesselmann
- Helios Klinikum Wuppertal, Department of Dermatology; Allergology, and Surgical Dermatology; Wuppertal; Germany
| | - Michael J. Flaig
- Clinic and Polyclinic for Dermatology and Allergology; University of Munich; Germany
| | - Thomas Ruzicka
- Clinic and Polyclinic for Dermatology and Allergology; University of Munich; Germany
| | - Walter Burgdorf
- Clinic and Polyclinic for Dermatology and Allergology; University of Munich; Germany
| | - Percy Lehmann
- Helios Klinikum Wuppertal, Department of Dermatology; Allergology, and Surgical Dermatology; Wuppertal; Germany
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11
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Nofal A, Assaf M, Tawfik A, Elsayed N, Nofal E, Elnakib N, Elmosalamy K. Progressive nodular histiocytosis: a case report and literature review. Int J Dermatol 2012; 50:1546-51. [PMID: 22098005 DOI: 10.1111/j.1365-4632.2011.04904.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ahmad Nofal
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
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12
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Batista AC, Mendonça EF, Arantes Elias LS, Andrade BAB, Almeida OP, León JE. Nonlipidized juvenile xanthogranuloma: an unusual variant with a potential diagnostic pitfall. Int J Pediatr Otorhinolaryngol 2012; 76:295-9. [PMID: 22204961 DOI: 10.1016/j.ijporl.2011.11.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 11/12/2011] [Indexed: 11/26/2022]
Abstract
Juvenile xanthogranuloma (JXG) is a histiocytic inflammatory disorder that can present different histologic patterns. Classic JXG consists of sheets of foamy histiocytes and numerous multinucleated Touton giant cells. Nonlipidized JXG (NJXG) is one of the unusual variants of JXG, consisting of a diffuse monomorphic infiltrate of mononuclear histiocytes, suggesting an aggressive or malignant tumor due the high mitotic index. However, NJXG behaves clinically as classic JXG. We present an unusual case of a 6-year-old boy who presented an exophytic ulcerated nodule on the lower lip diagnosed as NJXG. The boy is currently well without recurrence three years after surgical excision.
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Affiliation(s)
- Aline Carvalho Batista
- Department of Stomatology (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Brazil
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13
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L'vov AN, Voloshchuk IN, Varshavskiy VA, Gorbacheva YV, Bobko SI, LVOV AN, VOLOSHCHUK IN, VARSHAVSKY VA, GORBACHEVA YUV, BOBKO SI. Sinus histiocytosis (Rosai-Dorfman disease): a clinical observation. VESTNIK DERMATOLOGII I VENEROLOGII 2011. [DOI: 10.25208/vdv1076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The authors characterized a heterogeneous group of a rare disease - Langerhans and non-Langerhans cell histiocytosis,
and analyzed key differential and diagnostic differences between these forms of the disease. A very rare case of non-
Langerhans cell histiocytosis (Rosai-Dorfman disease) in a female patient aged 63 with the subsequent spontaneous
regression of eruptions was described. Key skin manifestations of the Rosai-Dorfman disease included papular eruptions
of the typical intense pink color with a yellowish and brown tint. Morphologic changes were characterized by proliferation
of histiocytes and accumulation of different lipids and pentalamellar markers (S-100 protein, СD 14, СD 68, lysozyme)
in their cytoplasm. Though the Rosai-Dorfman disease usually involves lymph nodes, this case was characterized by
unaffected nodular structures.
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14
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Chuang FC, Chern E, Wu WM. Progressive nodular histiocytosis: a rare type of xanthogranuloma. DERMATOL SIN 2011. [DOI: 10.1016/j.dsi.2011.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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