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Wang J, Wang Y, Li G, Wang C, Yu G, Sun Y. Rosai-Dorfman disease originating from nasal septal mucosa and presenting with nasal dorsum collapse: A case report with literature review. EAR, NOSE & THROAT JOURNAL 2022:1455613221079500. [PMID: 35171732 DOI: 10.1177/01455613221079500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is an uncommon histiocytic disease with idiopathic etiology and unique pathology. Extra-nodal RDD that occurs in the nasal cavity is extremely unusual and the characteristic clinical features are unknown. Herein, we report a case of nasal septum RDD, with intermittent epistaxis from the left nasal cavity, which led to collapse of the nasal bridge. The patient underwent surgical biopsy, and a diagnosis of nasal septum RDD was established. No further treatment was performed. An enlarged mass was found in the second postoperative year which was treated by surgical excision in the third postoperative year. To improve the current diagnostic and therapeutic approach of extra-nodal RDD, we incorporate previous reports from the literature to discuss the pathological characteristics, pathogenesis, clinical manifestations, diagnosis, and therapy for this rare disease.
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Affiliation(s)
- Junxin Wang
- School of Clinical Medicine, Weifang Medical University, Weifang, China
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, 117747Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, China
| | - Yan Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, 117747Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, China
| | - Guangjin Li
- School of Clinical Medicine, Weifang Medical University, Weifang, China
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, 117747Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, China
| | - Chen Wang
- School of Clinical Medicine, Weifang Medical University, Weifang, China
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, 117747Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, China
| | - Guohua Yu
- Department of Pathology, Yantai Yuhuangding Hospital, 117747Qingdao University, Yantai, China
| | - Yan Sun
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, 117747Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, China
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Ryu H, Hwang JY, Kim YW, Kim TU, Jang JY, Park SE, Yang EJ, Shin DH. Rosai-Dorfman disease in the spleen of a pediatric patient: A case report. World J Clin Cases 2021; 9:6032-6040. [PMID: 34368324 PMCID: PMC8316970 DOI: 10.12998/wjcc.v9.i21.6032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/14/2021] [Accepted: 05/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Rosai–Dorfman disease (RDD) is a rare histiocytic proliferation of unknown etiology commonly found in children and adolescents. The common manifestation of RDD is massive and painless bilateral cervical lymphadenopathy with extranodal disease. While extranodal involvement in RDD is common, the spleen is an infrequent site of disease.
CASE SUMMARY We report a 10-mo-old female infant with RDD presenting multiple splenic masses without cervical lymphadenopathy. She had fever, and blood tests showed leukocytosis, anemia, and elevated erythrocyte sedimentation rate and C-reactive protein. Ultrasound, computed tomography, and magnetic resonance images demonstrated multiple splenic masses. Despite antibiotic therapy, her symptoms were not relived. She underwent diagnostic splenectomy and was discharged with recovery.
CONCLUSION In pediatric patients with refractory infectious symptoms or hematological abnormalities, clinicians should suspect RDD, even in patients without significant lymphadenopathy.
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Affiliation(s)
- Hwaseong Ryu
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Yong-Woo Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Tae-Un Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Joo-Yeon Jang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Su-Eun Park
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan 50612, South Korea
| | - Eu-Jeen Yang
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan 50612, South Korea
| | - Dong-Hoon Shin
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
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Yang X, Fang C, Sha Y, Li Q, Zhang X, Du F, Tian W. An extremely rare case of Rosai-Dorfman disease in the spleen. BMC Surg 2021; 21:24. [PMID: 33407333 PMCID: PMC7789675 DOI: 10.1186/s12893-020-01014-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Rosai-Dorfman disease (RDD) is a rare, multisystemic histiocytic disorder, and commonly manifesting as lymphadenopathy in the young male. Abdominal manifestations of RDD are extremely rare. CASE PRESENTATION In August 2018, a 42-year-old man underwent an abdominal ultrasonography examination due to his weight loss of 10 kg in only three months and found a giant solid tumor was found in his spleen. Then, he was admitted to our hospital and diagnosed as a splenic mass via abdominal enhanced CT and MRI. Laparoscopic splenectomy was administrated within six days of admission due to the clear surgical indications. The pathogenesis of RDD remained poorly understood and the disease should be diagnosed based on histopathology and immunohistochemistry (IHC). The mutations in ATM and NFKBIA were observed using next generation sequencing (NGS). CONCLUSION We reported a case of splenic involvement of RDD with NGS genetic testing, indicating the difficulty of making a diagnosis before surgery. This extremely rare case offers new references for the understanding of abdominal viscera RDD.
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Affiliation(s)
- Xuewu Yang
- Binhai Hospital of Tianjin Medical University General Hospital, Tianjin, China
| | - Chuang Fang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuanpu Sha
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Qi Li
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Zhang
- State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd, Nanjing, China
| | - Furong Du
- State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd, Nanjing, China
| | - Weijun Tian
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China.
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Eliassen E, Krueger G, Luppi M, Ablashi D. Lymphoproliferative Syndromes Associated with Human Herpesvirus-6A and Human Herpesvirus-6B. Mediterr J Hematol Infect Dis 2018; 10:e2018035. [PMID: 29755712 PMCID: PMC5937953 DOI: 10.4084/mjhid.2018.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 04/26/2018] [Indexed: 12/28/2022] Open
Abstract
Human herpesvirus 6A and 6B (HHV-6A and HHV-6B) have been noted since their discovery for their T-lymphotropism. Although it has proven difficult to determine the extent to which HHV-6A and HHV-6B are involved in the pathogenesis of many diseases, evidence suggests that primary infection and reactivation of both viruses may induce or contribute to the progression of several lymphoproliferative disorders, ranging from benign to malignant and including infectious mononucleosis-like illness, drug induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS), and nodular sclerosis Hodgkin's lymphoma. Herein, we discuss the conditions associated with the lymphoproliferative capacity of HHV-6, as well as the potential mechanisms behind them. Continued exploration on this topic may add to our understanding of the interactions between HHV-6 and the immune system and may open the doors to more accurate diagnosis and treatment of certain lymphoproliferative disorders.
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Affiliation(s)
- Eva Eliassen
- HHV-6 Foundation, Santa Barbara, California, USA
| | - Gerhard Krueger
- Department of Pathology and Laboratory Medicine, University of Texas, Houston, Texas, USA
| | - Mario Luppi
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Garza-Guajardo R, García-Labastida LE, Rodríguez-Sánchez IP, Gómez-Macías GS, Delgado-Enciso I, Chaparro MMS, Barboza-Quintana O. Cytological diagnosis of Rosai-Dorfman disease: A case report and revision of the literature. Biomed Rep 2016; 6:27-31. [PMID: 28123703 PMCID: PMC5244775 DOI: 10.3892/br.2016.814] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 10/21/2016] [Indexed: 11/30/2022] Open
Abstract
Rosai-Dorfman disease also known as sinus histiocytosis with massive lymphadenopathy (SHML) is characterized by distorted lymph node architecture with marked dilation of lymphatic sinuses occupied by numerous lymphocytes, as well as histiocytes with vesicular nucleus and abundant clear cytoplasm with phagocytized lymphocytes or plasma cells, also known as ‘emperipolesis’. This disease of unknown etiology progresses with a benign prognosis strictly and only when an early diagnosis and treatment is made. A late diagnosis and a generalized lymph node involvement contribute to a poor prognosis. In this study, we focussed on the cytological characteristics of the Rosai-Dorfman disease and differential diagnoses. We reported a case of a 61-year-old Mexican male with a 9-month history of painless bilateral cervical masses and low-grade fever with the final diagnosis of Rosai-Dorfman disease. The final diagnosis was made by fine needle aspiration (FNA) biopsy of parotid gland and cervical lymph node. In conclusion, FNA biopsy can be enough to make the diagnosis in most cases due to the distinct cytological features of SHML, thereby avoiding more invasive approaches that potentially are unnecessary.
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Affiliation(s)
- Raquel Garza-Guajardo
- Department of Pathological Anatomy and Cytopathology, University Hospital 'Dr José Eleuterio González', Autonomous University of Nuevo León, Monterrey, Nuevo Leon 64460, Mexico
| | - Laura Elvira García-Labastida
- Department of Pathological Anatomy and Cytopathology, University Hospital 'Dr José Eleuterio González', Autonomous University of Nuevo León, Monterrey, Nuevo Leon 64460, Mexico
| | - Iram Pablo Rodríguez-Sánchez
- Department of Genetics, School of Medicine, Autonomous University of Nuevo León, Monterrey, Nuevo Leon 64460, Mexico
| | - Gabriela Sofía Gómez-Macías
- Department of Pathological Anatomy and Cytopathology, University Hospital 'Dr José Eleuterio González', Autonomous University of Nuevo León, Monterrey, Nuevo Leon 64460, Mexico
| | | | - María Marisela Sánchez Chaparro
- Laboratory of Immunology and Virology, Faculty of Biological Sciences, Autonomous University of Nuevo León, San Nicolas de los Garza, Nuevo Leon 66420, Mexico
| | - Oralia Barboza-Quintana
- Department of Pathological Anatomy and Cytopathology, University Hospital 'Dr José Eleuterio González', Autonomous University of Nuevo León, Monterrey, Nuevo Leon 64460, Mexico
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Wang CC, Al-Hussain TO, Serrano-Olmo J, Epstein JI. Rosai-Dorfman disease of the genito-urinary tract: analysis of six cases from the testis and kidney. Histopathology 2014; 65:908-16. [DOI: 10.1111/his.12494] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 07/05/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Chung-Chieh Wang
- Department of Pathology; National Taiwan University Hospital and College of Medicine; National Taiwan University; Taipei Taiwan
| | - Turki O Al-Hussain
- Department of Pathology; King Faisal Specialist Hospital; Riyadh Saudi Arabia
| | - Juan Serrano-Olmo
- Department of Pathology; Hospital Hima-San Pablo Bayamon; Bayamon Puerto Rico
| | - Jonathan I Epstein
- Departments of Pathology, Urology and Oncology; The Johns Hopkins Hospital; Baltimore MD USA
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Steroid-resistant extranodal rosai-dorfman disease of cheek mass and ptosis treated with radiation therapy. Case Rep Hematol 2013; 2013:428297. [PMID: 23738161 PMCID: PMC3659441 DOI: 10.1155/2013/428297] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 04/08/2013] [Indexed: 12/02/2022] Open
Abstract
Background. Rosai-Dorfman Disease (RDD) is rare benign hematologic disorder of histiocytes, which usually manifests as painless lymphadenopathy, fever, leukocytosis and hypergammaglobulinemia. Extranodal RDD has been reported in 43% of cases, with skin as commonly involved site followed by head and neck region. However, soft tissue cheek mass is rare presentation of extra-nodal RDD. Case Presentation. A 26-year-old Saudi man presented with a six-month history of right cheek swelling and left upper eyelid swelling. Physical examination revealed right cheek mass of size 3 × 3 cm and left upper eyelid mass of size 1 × 2 cm and no palpable cervical lymphadenopathy. Incisional biopsy of cheek mass showed positivity for S100 and negativity for CD1a, consistent with extra-nodal RDD. Patient did not respond to systemic steroids and was given radiation therapy to left orbit with minimal response. Then, he was started on chemotherapy Rituximab, cyclophosphamide, vincristine, and prednisolone (RCVP) 8 cycles followed by reirradiation 10 Gy in 10 fractions with 6 MeV electron with complete response. After 12 months of followup, patient had recurrence in right cheek and was started on radiotherapy to the cheek mass. Conclusion. Extra-nodal RDD with involvement of cheek is a rare presentation. Incorporation of S100 and CD1a is helpful in diagnoses of RDD and differentiating it from other benign histiocytosis. Treatment consists of surgery, steroids, chemotherapy, and radiation therapy.
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