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Kisu E, Hiraki M, Okuyama K, Maeda S, Takesue S, Kusaba K, Kai K, Manabe T, Noshiro H. Multiple foci of Rosai-Dorfman disease in colon: a case report. Surg Case Rep 2024; 10:173. [PMID: 39026023 PMCID: PMC11258111 DOI: 10.1186/s40792-024-01973-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 07/12/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Rosai-Dorfman disease (RDD) is an uncommon proliferative histiocytic disorder involving lymph nodes and various organs. Forty-three percent of RDD cases originate from extranodal sites; however, RDD rarely arises from the colon. CASE PRESENTATION A 75-year-old man was admitted to our hospital because of intra-abdominal masses that were incidentally detected during surveillance by computed tomography (CT) after treatment for lung cancer. Enhanced CT showed two mass lesions located in the cecum to the appendix (diameter, 40 mm) and around the sigmoid colon (diameter, 24 mm). Positron emission tomography (PET)-CT revealed an apparent uptake of fluorodeoxyglucose. Intraluminal endoscopy did not reveal definite mucosal abnormalities. These findings suggest the presence of malignant neoplasms including gastrointestinal stromal tumors, lung cancer metastasis, and malignant lymphoma. Exploratory laparoscopy and/or tumor excision were planned to obtain a definitive diagnosis. Based on laparoscopic findings, ileocecal resection and sigmoidectomy were simultaneously performed to excise the tumors. Postoperative histopathological examination revealed multiple RDD originating from the mesocolon side of the cecum and the sigmoid colon. The patient did not receive any adjuvant therapy. No recurrence was observed one year after surgery. CONCLUSION RDD originating from the colon is extremely rare. Tumor extirpation or organ resection is sometimes required to obtain a definitive diagnosis of RDD, and minimally invasive surgery is helpful.
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Affiliation(s)
- Eri Kisu
- Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Masatsugu Hiraki
- Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
| | - Keiichiro Okuyama
- Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Sachiko Maeda
- Department of Pathology, Saga University Faculty of Medicine, Saga, Japan
| | - Shin Takesue
- Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Kana Kusaba
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Keita Kai
- Department of Pathology, Saga University Faculty of Medicine, Saga, Japan
| | - Tatsuya Manabe
- Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Hirokazu Noshiro
- Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan
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Rathinam A, Gupta S, Khanam R, Sahai T. A Case of Rosai-Dorfman Disease Presenting as an Isolated Pleural Plaque. Cureus 2023; 15:e41334. [PMID: 37546096 PMCID: PMC10398612 DOI: 10.7759/cureus.41334] [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: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare non-Langerhans histiocytic disorder primarily involving lymph nodes. Extranodal RDD has a heterogenous presentation, and isolated pulmonary involvement is rare. We report the only case of RDD presenting as an isolated pleural mass. Our patient was a 55-year-old female with multiple comorbidities who presented with chest pain. Imaging revealed an enlarging pleural-based lesion. She underwent resection of the pleural mass, showing an atypical histiocytic infiltrate in a prominent background of collagenous fibrosis. Immunohistochemistry shows CD1a-negative and S100-positive atypical histiocytic cells demonstrating emperipolesis, confirming the diagnosis of RDD. She is currently on six-month CT surveillance with no recurrence of the disease. This case highlights the unique pulmonary presentation of RDD. It also underscores that observations may be appropriate in isolated asymptomatic pleural involvement cases.
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Affiliation(s)
- Arun Rathinam
- Internal Medicine, Carle Foundation Hospital, Urbana, USA
| | - Sushan Gupta
- Internal Medicine, Carle Foundation Hospital, Urbana, USA
| | | | - Tanmay Sahai
- Hematology and Oncology, Carle Foundation Hospital, Urbana, USA
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Cohen-Aubart F, Ungureanu I, Razanamahery J, Charlotte F, Valmary-Degano S, Hélias-Rodzewicz Z, Cazals-Hatem D, Dartigues P, Delage-Corre M, Selves J, Tas P, Humbert S, Malakhia A, Kunnamo M, Veresezan L, Prokopiou C, Seeber A, Tazi A, Donadieu J, Lucidarme O, Haroche J, Emile JF. Peritoneal or mesenteric tumours revealing histiocytosis. BMJ Open Gastroenterol 2021; 8:bmjgast-2021-000622. [PMID: 34020934 PMCID: PMC8144026 DOI: 10.1136/bmjgast-2021-000622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/13/2021] [Accepted: 05/01/2021] [Indexed: 01/31/2023] Open
Abstract
Objective Peritoneal or mesenteric tumours may correspond to several tumour types or tumour-like conditions, some of them being represented by histiocytosis. This rare condition often poses diagnostic difficulties that can lead to important time delay in targeted therapies. Our aim was to describe main features of histiocytoses with mesenteric localisation that can improve the diagnostic process. Design We performed a retrospective study on 22 patients, whose peritoneal/mesenteric biopsies were infiltrated by histiocytes. Results Abdominal pain was the revealing symptom in 10 cases, and 19 patients underwent surgical biopsies. The diagnosis of histiocytosis was proposed by initial pathologists in 41% of patients. The other initial diagnoses were inflammation (n=7), sclerosing mesenteritis (n=4) and liposarcoma (n=1). The CD163/CD68+CD1a- histiocytes infiltrated subserosa and/or deeper adipose tissues in 16 and 14 cases, respectively. A BRAFV600E mutation was detected within the biopsies in 11 cases, and two others were MAP2K1 mutated. The final diagnosis was histiocytosis in 18 patients, 15 of whom had Erdheim-Chester disease. The median diagnostic delay of histiocytosis was 9 months. Patients treated with BRAF or MEK inhibitors showed a partial response or a stable disease. One patient died soon after surgery, and five died by the progression of the disease. Conclusion Diagnosis of masses arising in the mesentery should be carefully explored as one of the possibilities in histiocytosis. This diagnosis is frequently missed on mesenteric biopsies. Molecular biology for detecting the mutations in BRAF or in genes of the MAP kinase pathway is a critical diagnostic tool.
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Affiliation(s)
- Fleur Cohen-Aubart
- Sorbonne University, Paris, Île-de-France, France.,Service de Médecine Interne et Centre National de Référence Maladies Systémiques Rares et Histiocytoses, University Hospital Pitié Salpêtrière, Paris, Île-de-France, France
| | - Irena Ungureanu
- Department of Pathology, Hôpital Ambroise-Pare, Boulogne-Billancourt, Île-de-France, France.,Department of Pathology, University Emergency Hospital Bucharest, Bucharest, Romania
| | - Jerome Razanamahery
- Department of Internal Medicine and Clinical Immunology, University Hospital Centre Dijon, Dijon, France
| | - Frédéric Charlotte
- Department of Pathology, University Hospital Pitié Salpêtrière, Paris, Île-de-France, France
| | - Séverine Valmary-Degano
- Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, University Grenoble Alpes, Grenoble, Rhône-Alpes, France
| | - Zofia Hélias-Rodzewicz
- Department of Pathology, Hôpital Ambroise-Pare, Boulogne-Billancourt, Île-de-France, France.,EA4340-BECCOH, Versailles Saint-Quentin-en-Yvelines University, Versailles, Île-de-France, France
| | | | - Peggy Dartigues
- Department of Pathology, Gustave Roussy Institute, Villejuif, Île-de-France, France
| | | | - Janick Selves
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, Occitanie, France
| | - Patrick Tas
- Department of Pathology, CHU Pontchaillou, Rennes, Bretagne, France
| | - Sebastien Humbert
- Department of Internal Medicine and Clinical Immunology, University Hospital Centre Dijon, Dijon, France
| | - Alexandre Malakhia
- Department of Radiology, University Hospital Centre Besancon, Besancon, France
| | - Merja Kunnamo
- Department of Medicine, Central Finland Central Hospital, Jyvaskyla, Central Finland, Finland
| | - Liana Veresezan
- Department of Pathology, Centre Henri Becquerel, Rouen, Haute-Normandie, France
| | | | - Andreas Seeber
- Medical University of Innsbruck, Innsbruck, Austria.,Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Innsbruck, Austria
| | - Abdellatif Tazi
- Centre National de Référence des Histiocytoses, Department of Pneumology, Hospital Saint-Louis, Paris, Île-de-France, France.,FR-75006, Université de Paris, Paris, Île-de-France, France
| | - Jean Donadieu
- EA4340-BECCOH, Versailles Saint-Quentin-en-Yvelines University, Versailles, Île-de-France, France.,Department of Pediatric Hematology and Oncology, Centre de Référence des Histiocytoses, Hôpital Armand-Trousseau, Paris, Île-de-France, France
| | - Olivier Lucidarme
- Department of Radiology, University Hospital Pitié Salpêtrière, Paris, Île-de-France, France.,CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Sorbonne University, Paris, Île-de-France, France
| | - Julien Haroche
- Sorbonne University, Paris, Île-de-France, France.,Service de Médecine Interne et Centre National de Référence Maladies Systémiques Rares, University Hospital Pitié Salpêtrière, Paris, Île-de-France, France
| | - Jean-François Emile
- Department of Pathology, Hôpital Ambroise-Pare, Boulogne-Billancourt, Île-de-France, France .,EA4340-BECCOH, Versailles Saint-Quentin-en-Yvelines University, Versailles, Île-de-France, France
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