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Chen X, An L, Jiang Z, Jia Y. A case report of multicentric reticulohistiocytosis with atypical cutaneous presentation. Front Immunol 2024; 15:1344313. [PMID: 38426104 PMCID: PMC10903083 DOI: 10.3389/fimmu.2024.1344313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
Multicentric reticulohistiocytosis (MRH) is a rare systemic disorder characterized by histiocytic hyperplasia that mainly involves the skin, mucous membranes, and joints. The typical clinical features include papules, nodules, and arthritis. MRH lesions are relatively extensive but small and scattered. Joint inflammation is characterized by diffuse symmetric polyarthritis as the first symptom, which can be severe and disabling due to destructive joint changes. MRH is easily misdiagnosed in clinical practice. Here, we report the case of an elderly male patient who presented with polyarticular pain in the hip and interphalangeal joints as the first manifestation, followed by the development of large, isolated, bulging skin nodules, which are atypical MRH lesions. This is rare in all MRH case reports, and we made the correct diagnosis by combining skin histopathology, immunohistochemistry, and other clinical examinations. We performed surgical treatment on the local skin lesions of this patient. This case suggests that clinicians should actively correlate the condition and accurately diagnose MRH when encountering atypical skin changes or other diseases as the first symptom and explore the mechanisms of MRH and other clinical manifestations.
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Affiliation(s)
| | | | | | - Yuxi Jia
- Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
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2
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Affiliation(s)
- Rikita Paonam
- Department of Dermatology, Venereology and Leprosy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Konsam Nirupama Devi
- Department of Dermatology, Venereology and Leprosy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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3
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Liu JR, Yang YF. Huge solitary reticulohistiocytoma with infection: A rare case report. Asian J Surg 2023; 46:1315-1316. [PMID: 36114068 DOI: 10.1016/j.asjsur.2022.08.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/24/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jing-Ru Liu
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, China; Shandong University Cancer Center, Jinan, 250117, China
| | - Yi-Fan Yang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, China.
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4
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Luo S, Tan Y, Zhang G. A Rare Case of Pediatric Xanthoma Disseminatum With Diabetes Insipidus and BRAF p.V600E Mutation. Am J Dermatopathol 2022; 44:287-290. [PMID: 34966053 DOI: 10.1097/dad.0000000000002117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Xanthoma disseminatum (XD) is a rare non-Langerhans cell histiocytosis characterized by xanthomatous lesions in the absence of hyperlipidemia. XD usually develops in young adults, and there are rare cases among children. BRAF mutations are frequent in Langerhans cell histiocytosis and Erdheim-Chester disease but absent or only rarely detected in other histiocytosis. Herein, we described a 6-year-old Chinese girl presented with generalized skin lesions and diabetes insipidus for 5 months. There were multiple periorbital xanthelasma with histopathological features of foamy histiocytes infiltration with Touton cells. Pituitary magnetic resonance imaging showed pituitary enlargement and pituitary stalk thickening. The presence of BRAF p.V600E mutation makes this case distinctive and also offers a potential therapeutic target. According to our review of the literature, this is the first pediatric XD with diabetes insipidus and BRAF mutation.
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Affiliation(s)
- Shuaihantian Luo
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China
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Abstract
ABSTRACT Multicentric reticulohistiocytosis (MRH) is a rare multisystem disorder, primarily affecting the skin and joints. As severe joint damage is a possible symptom, early diagnosis and therapeutic intervention are required. Cutaneous lesions present with characteristic features such as discrete reddish nodules, especially on acral locations. Additionally, the face, scalp, trunk and extremities are also affected. Xanthomatous plaques are also seen on the face. The cutaneous manifestations of MRH are various, which therefore should be differentiated from several diseases. In particular, MRH has been reported to assume clinical appearances resembling Gottron papules, periungual erythema, V-neck erythema, shawl sign, and poikiloderma associated with dermatomyositis. Histopathologic features show proliferation of multinucleated giant cells with abundant eosinophilic granular ground glass-like cytoplasm in the dermis. Multicentric reticulohistiocytosis is occasionally paraneoplastic and is associated with internal malignancies. The appropriate therapies are still challenging, and oral prednisolone, immunosuppressants, and recent biologics are used. In this article, cutaneous lesions, histopathology, and pathogenesis of MRH are mainly discussed from a dermatological perspective. It is important, not only for dermatologists but also for rheumatologists and orthopedists, to be able to distinguish between the various types of skin lesions brought on by MRH. Cutaneous signs are important diagnostic clues and assessment tools for therapeutic efficacy.
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Affiliation(s)
- Toshiyuki Yamamoto
- From the Department of Dermatology, Fukushima Medical University, Fukushima, Japan
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Fronek L, Bindernagel R, Segars K, Miller R. Multicentric reticulohistiocytosis masquerading as cutaneous connective tissue disease. Dermatol Online J 2021; 27:13030/qt37h8p3rp. [PMID: 33865276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023] Open
Abstract
Multicentric reticulohistiocytosis (MRH) is a rare type of non-Langerhans cell histiocytosis characterized by coral-toned papules with predilection for dorsal surfaces in addition to severe arthropathy. It sometimes proves difficult to differentiate these joint and skin findings clinically from certain rheumatologic diseases, primarily dermatomyositis. Herein, we present an 82-year-old woman who presented with the clinical findings described above and was subsequently diagnosed with MRH after biopsy and review of relevant clinical history. Because about 25% of patients diagnosed with MRH have an underlying occult malignancy, our patient underwent a complete malignancy workup that was negative. She was treated with systemic corticosteroids and methotrexate, which resulted in an improvement of the arthritis and constitutional symptoms. This case demonstrates that in patients with both rheumatologic and dermatologic symptoms, particularly on acral surfaces, MRH must be a diagnostic consideration. Identifying this disease early in its course can prevent negative consequences for the patients, specifically arthritis mutilans and upper airway involvement.
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Affiliation(s)
| | | | | | - Richard Miller
- Department of Dermatology, HCA Healthcare/USF Morsani College of Medicine Largo, FL.
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Affiliation(s)
- Gloria Orlando
- Department of Dermatology, University of Padova, IT-35128 Padova, Italy
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8
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Franco L, Miller K, Patel RR, Bost SJ, Ramachandran SM. Multicentric reticulohistiocytosis with arthralgia and red-orange papulonodules. Cutis 2019; 103:E20-E22. [PMID: 30758349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Loren Franco
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kristen Miller
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, USA
| | - Rishi R Patel
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, USA
| | - Sandra J Bost
- Affiliated Dermatologists, Morristown, New Jersey, USA
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Abstract
Reticulohistiocytomas represent a group of benign histiocytic dermal proliferations, which occur either sporadically as solitary cutaneous nodules or, when multiple, in association with systemic disease. Due to its nonspecific clinical presentation, reticulohistiocytoma may mimic other benign or malignant skin neoplasms; therefore, in most cases, a biopsy is needed in order to establish the correct diagnosis. The histology is typically characterized by the presence of large histiocytes with abundant eosinophilic cytoplasm with immunohistochemical profile positive for CD68, CD163, and vimentin. The authors report the case of a patient with solitary reticulohistiocytoma with illustrative clinical, dermoscopic, and histologic features.
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Affiliation(s)
- Katarina Kieselova
- Department of Dermatology, Centro Hospitalar de Leiria, Leiria,
Portugal
| | | | - Cristina Amado
- Department of Pathology, Centro Hospitalar de Leiria, Leiria,
Portugal
| | - Martinha Henrique
- Department of Dermatology, Centro Hospitalar de Leiria, Leiria,
Portugal
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Winkler JK, Hanner S, Rütten A, Enk AH, Haenssle H, Toberer F. Yellow-brown Papules on the Cheeks and Limbs of a Male Infant: A Quiz. Acta Derm Venereol 2018; 98:620-621. [PMID: 29437191 DOI: 10.2340/00015555-2907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Julia K Winkler
- Department of Dermatology, Venerology and Allergology, University Medical Center, Ruprecht-Karls-University, Im Neuenheimer Feld 440, DE-69120 Heidelberg, Germany.
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Abstract
A case of splenic large B-cell lymphoma with hemophagocytic syndrome is reported. The difficulties of diagnosis are emphasized especially when peripheral lymph nodes or bone marrow lymphomatous infiltration are not present. Diagnostic criteria for hemophagocytic syndrome and their relationship with the pathogenesis of the disease are also stressed.
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Affiliation(s)
- G Büchi
- Divisione di Medicina Interna, Ospedale Civile di Ivrea, Italy
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Affiliation(s)
- Hui Zi Gong
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - He Yi Zheng
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Li
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Anderson AM, Todberg T, Kofoed K, Iversen TZ, Andersen M, Hjorth SV, Fassi DE. [Multicentric reticulohistiocytosis is a rare form of paraneoplasia]. Ugeskr Laeger 2018; 180:V08170611. [PMID: 29298742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 59-year-old woman developed a rash and severe arthralgia, which primarily affected her fingers. She displayed digital arthritis and nodules on the hands, chest, face, and oral cavity. Blood samples were normal. Skin biopsies revealed histiocytic proliferation. The surface marker profile and clinical findings were consistent with multicentric reticulohistiocytosis, which may occur as a paraneoplastic phenomenon. On workup, she was diagnosed with an otherwise asymptomatic stage IVC fallopian tube cancer. She experienced little effect of prednisolone, but her condition improved on antineoplastic treatment.
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Baranowski ML, Chisolm SS, Stoff BK, Blalock TW. Orange nodules on the scalp. Cutis 2017; 100:157-160. [PMID: 29121129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Sarah S Chisolm
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Benjamin K Stoff
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Travis W Blalock
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA
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15
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Woodruff CM, Schulman JM, Amerson EH. Progressive papular eruption on the face and groin. Cutis 2017; 99:E4-E6. [PMID: 28319628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Carina M Woodruff
- Department of Dermatology, University of California, San Francisco, USA
| | - Joshua M Schulman
- Department of Dermatology, University of California Davis Health System, Sacramento, USA
| | - Erin H Amerson
- Department of Dermatology, University of California, San Francisco, USA
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Abstract
A 68-year-old man presented with polyarthritis, proximal muscle weakness, and erythema of the face, arms, neck, and anterior chest that resembled the V-neck sign. Initially, dermatomyositis (DM) was considered because of the erythema, polyarthritis, and muscle weakness. He also had mediastinal and hilar lymphadenopathy on contrast-enhanced computed tomography. Unexpectedly, a biopsy of the forehead skin revealed numerous multinucleated giant cells. A biopsy of a solitary nodule on the dorsum of his right middle finger revealed similar multinucleated giant cells with ground-glass cytoplasm, leading to the diagnosis of multicentric reticulohistiocytosis (MRH). Although MRH is rare, it should be remembered that MRH can mimic DM.
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Affiliation(s)
- Natsuki Shima
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
| | - Takamasa Murosaki
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
| | - Takao Nagashima
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
| | - Masahiro Iwamoto
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
| | - Yusuke Amano
- Department of Diagnostic Pathology, Jichi Medical University, Japan
| | - Naomi Nakano
- Department of Dermatology, Jichi Medical University, Japan
| | | | - Seiji Minota
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
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Pinney SS, Jahan-Tigh RR, Chon S. Generalized eruptive histiocytosis associated with a novel fusion in LMNA-NTRK1. Dermatol Online J 2016; 22:13030/qt07d3f2xk. [PMID: 27617936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 08/17/2016] [Indexed: 06/06/2023] Open
Abstract
Non-Langerhans cell histiocytosis (NLCH) is a histiocyte disorder comprised of dermal dendritic histiocytes with a characteristic staining pattern. Erdheim-Chester disease (ECD) is a subset of NLCH in which patients experience bone pain with corresponding changes on imaging. In addition, these patients show other evidence of systemic involvement, which can also be identified with imaging. This disease can occasionally present with cutaneous findings. We present a case of generalized eruptive histiocytosis (GEH), misdiagnosed as ECD, found to have an NTRK1 gene rearrangement. This is the first report of an NTRK1 kinase fusion with NLCH. The implication is unclear and further studies are warranted.
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Affiliation(s)
- Sarah S Pinney
- University of Texas Health Sciences Center at Houston-UT Health, Dept. of Dermatology.
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Motegi SI, Yonemoto Y, Yanagisawa S, Toki S, Uchiyama A, Yamada K, Ishikawa O. Successful Treatment of Multicentric Reticulohistiocytosis with Adalimumab, Prednisolone and Methotrexate. Acta Derm Venereol 2016; 96:124-5. [PMID: 26072967 DOI: 10.2340/00015555-2170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sei-Ichiro Motegi
- Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
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Lange M, Iżycka-Świeszewska E, Michajłowski I, Barańska-Rybak W. Benign cephalic histiocytosis. Cutis 2015; 95:E15-E17. [PMID: 26125216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Magdalena Lange
- Department of Dermatology, Venereology, and Allergology, Medical University of Gdansk, Debinki St 7, 80-211, Gdansk, Poland.
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Zinoun M, Hali F, Marnissi F, Lazaar S, Benchikhi H. [Xanthoma disseminatum with asymptomatic multisystem involvement]. Ann Dermatol Venereol 2015; 142:276-80. [PMID: 25626620 DOI: 10.1016/j.annder.2014.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 10/04/2014] [Accepted: 11/13/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Xanthogranulomas belong to non-Langerhans histiocytosis of the second group in the Histiocyte Society classification. They comprise a heterogeneous group of rare entities frequently involving cutaneous tropism. Xanthoma disseminatum belongs to this group of non-Langerhans histiocytosis. We report a case of xanthoma disseminatum (XD) in which localized skin and mucous impairment revealed multisystem involvement. PATIENTS AND METHODS A 28-year-old man presented with a two-year history of progressive yellow-orange and infiltrated xanthomatous papulonodular lesions of the face. Lesions of the oral mucosa and genital region were seen, with no functional repercussions. No ophthalmic or other complications were found. Histopathology showed a dense histiocytic infiltrate within the dermis with Touton giant cells, foamy multinucleated giant cells and inflammatory cells, without necrobiosis. Histiocytes were positive for CD68 but negative for CD1a. Gastric and lung involvement was seen and was confirmed at histology. Bone scintigraphy showed suspicious left ulnar hyperfixation suggesting bone involvement. No monoclonal gammopathy or diabetes insipidus was seen. Our patient was treated with corticosteroids 1mg/kg/day and thalidomide 100 mg/day. The outcome was marked by regression and exfiltration of the cutaneous lesions from the second week of treatment, with subsidence continuing at 3 months. DISCUSSION This case involves a very rare form of xanthoma disseminatum. The localized facial skin lesions revealed multifocal non-Langerhans histiocytosis that was in fact asymptomatic. The diagnosis of XD was based on clinical, histological and immunohistochemical criteria. Xanthoma disseminatum is a non-Langerhans histiocytic proliferation first described by Montgomery in 1938. This rare entity is characterized by skin and mucous membrane xanthomatosis in which the facial involvement is common, together with diabetes insipidus and normal lipid metabolism. The prognosis is determined by the presence of mucosal xanthomas and visceral involvement. Thus, all xanthogranulomas involving multiple lesions warrant screening for visceral involvement. Diagnosis of this entity can be difficult and is usually based on clinical and histopathological findings. In addition, treatment is complex and non-consensual.
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Affiliation(s)
- M Zinoun
- Service de dermatologie-vénéréologie, CHU Ibn Rochd, 1, quartier des Hôpitaux, Casablanca, Maroc.
| | - F Hali
- Service de dermatologie-vénéréologie, CHU Ibn Rochd, 1, quartier des Hôpitaux, Casablanca, Maroc
| | - F Marnissi
- Service d'anatomopathologie, CHU Ibn Rochd, 1, quartier des Hôpitaux, Casablanca, Maroc
| | - S Lazaar
- Service de radiologie, CHU Ibn Rochd, 1, quartier des Hôpitaux, Casablanca, Maroc
| | - H Benchikhi
- Service de dermatologie-vénéréologie, CHU Ibn Rochd, 1, quartier des Hôpitaux, Casablanca, Maroc
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Affiliation(s)
- David A Kandiah
- School of Psychiatry and Neurosciences, University of Western Australia, Nedlands, Western Australia, Australia
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Cohen PR, Lee RA. Adult-onset reticulohistiocytoma presenting as a solitary asymptomatic red knee nodule: report and review of clinical presentations and immunohistochemistry staining features of reticulohistiocytosis. Dermatol Online J 2014; 20:doj_21725. [PMID: 24656263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 03/14/2014] [Indexed: 06/03/2023] Open
Abstract
Reticulohistiocytomas are benign dermal tumors that usually present as either solitary or multiple, cutaneous nodules. Reticulohistiocytosis can present as solitary or generalized skin tumors or cutaneous lesions with systemic involvement and are potentially associated with internal malignancy. A woman with a solitary red nodule on her knee is described in whom the clinical differential diagnosis included dermatofibroma and amelanotic malignant melanoma. Hematoxylin and eosin staining and immunoperoxidase studies of the biopsy specimen established the diagnosis of adult-onset reticulohistiocytoma (solitary epithelioid histiocytoma). Reticulohistiocytoma is characterized by mononuclear, and occasionally multinuclear, histiocytes with eosinophilic "glassy" cytoplasm. The immunohistochemical profile of a reticulohistiocytoma demonstrates consistent positive expression for CD68 (a marker that is expressed by histiocytes but can also show positive staining in melanomas and carcinomas), CD163 (a very specific marker for histiocytes), and vimentin. Reticulohistiocytomas show variable positive expression for MITF (microphthalmia transcription factor) and S100 protein, both of which are more commonly used as markers for melanocytes. Recurrence of a reticulohistiocytoma is rare, even for patients with an incompletely removed lesion. However, our patient elected to have her residual tumor completely excised.
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MESH Headings
- Adult
- Antigens, CD/analysis
- Antigens, Differentiation, Myelomonocytic/analysis
- Biomarkers/analysis
- Biopsy
- Diagnosis, Differential
- Female
- Histiocytes/chemistry
- Histiocytoma, Benign Fibrous/diagnosis
- Histiocytosis, Non-Langerhans-Cell/diagnosis
- Histiocytosis, Non-Langerhans-Cell/metabolism
- Histiocytosis, Non-Langerhans-Cell/pathology
- Humans
- Immunoenzyme Techniques
- Knee/pathology
- Melanocytes/chemistry
- Melanoma, Amelanotic/diagnosis
- Microphthalmia-Associated Transcription Factor/analysis
- Receptors, Cell Surface/analysis
- S100 Proteins/analysis
- Skin Neoplasms/diagnosis
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Affiliation(s)
- Philip R Cohen
- Division of Dermatology, University of California San Diego, San Diego, California.
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Park M, Boone B, Devos S. Xanthoma disseminatum: case report and mini-review of the literature. Acta Dermatovenerol Croat 2014; 22:150-154. [PMID: 25102803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Xanthoma disseminatum is a non-familial disorder of non-Langerhans cell origin or a class II histiocytosis with unknown etiology, with just over 100 cases reported in the literature. Because of the rarity of this disease, there is no established treatment. We studied clinical manifestations and different treatments of xanthoma disseminatum from a series of cases, including our own patient. We studied 15 articles on treatment of xanthoma disseminatum. Local treatment with cryotherapy, radiotherapy, surgery, and carbon dioxide lasers have been attempted with various results. Systemic medication with peroxisome proliferator-activated gamma receptors, statins, fenofibrate, chlorodeoxyadenosine, cyclophosphamide, doxycycline, and cyclosporine have also been reported, but none have proven particularly successful. Xanthoma disseminatum is usually benign and is often self-limiting. If the lesions are accessible to surgery, that is likely to give the best results. However, if the lesions are not accessible for surgical removal then carbon dioxide laser treatment may be considered. The choice of oral treatment should be made on the basis of the patient's condition, since none of them have proven particularly effective. Expectant management is justifiable as long as the lesions are limited to the skin.
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Affiliation(s)
- Michael Park
- Michael Park, MD Karel Janssenslaan 41, 8400 Oostende Belgium;
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Wat M, Sun GS, Rodriguez-Waitkus PM, Hsu S. Granuloma annulare mimicking multicentric reticulohistiocytosis. Dermatol Online J 2013; 19:20400. [PMID: 24314776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 11/15/2013] [Indexed: 06/02/2023] Open
Abstract
We describe a patient with granuloma annulare (GA) who presented with firm periungual papules mimicking "coral beads", a characteristic sign of multicentric reticulohistiocytosis (MRH). We highlight the importance of distinguishing between GA and MRH because the prognoses differ significantly.
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Toberer F, Hartschuh W, Witzens-Harig M, Enk AH, Lonsdorf AS. Intertriginous orange-to-brownish papules and plaques: a quiz. Xanthoma disseminatum. Acta Derm Venereol 2013; 93:493-4. [PMID: 23165822 DOI: 10.2340/00015555-1495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ferdinand Toberer
- Department of Dermatology, Ruprecht-Karls-University of Heidelberg, DE-69115 Heidelberg, Germany
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Amin SM, Riddle C, Fraga GR, Coquilla-Canete B, Cherian R, McGregor D. Progressive nodular histiocytosis with normal karyotypic analysis. Dermatol Online J 2013; 19:18577. [PMID: 24011326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 06/15/2013] [Indexed: 06/02/2023] Open
Abstract
Non-Langerhans cell histiocytoses (NLH) comprise a spectrum of diseases that includes sinus histiocytosis with massive lymphadenopathy, hemophagocytic lymphohistiocytosis, xanthogranuloma, and reticulohistiocytoma. Progressive nodular histiocytosis (PNH) is a rare NLH that microscopically mimics juvenile xanthogranuloma but presents with disseminated persistent and progressive papulonodules in adults. Herein, we describe a case of PNH presenting as diffuse, progressively enlarging papules, nodules, and pedunculated tumors in a 38-year-old male. The diagnosis is supported microscopically by the morphologic and immunohistochemical findings. Whereas conventional cytogenetic analysis of Langerhans cell histiocytosis and juvenile xanthogranuloma has previously been described, there are no reports of the karyotype of PNH. In our patient, conventional cytogenetic analysis of the tumor revealed a normal karyotype. Although these results may represent the overgrowth of normal stromal cells rather than lesional cells, we believe this to be an important finding, indicating karyotypic analysis will not allow for distinction between PCH and other NLH or Langerhans cell histiocytoses.
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Affiliation(s)
- Sapna M Amin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, USA
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Jung HD, Kim HS, Lee JY, Kim HO, Park YM. Papules, arthralgia, dry mouth and dry eyes: a quiz. Diagnosis: Multicentric reticulohistocytosis. Acta Derm Venereol 2013; 93:124-5. [PMID: 22367265 DOI: 10.2340/00015555-1327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hee Dam Jung
- Department of Dermatology, College of Medicine, The Catholic University of Korea 620-56, Jeonnong-dong, Dongdaemun-ku, Seoul, Korea
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de Inocencio Arocena J, Tejada Palacios P, Barceló Mendiguchía A, Enríquez Merayo E. [Clarifications on the article "sarcoidosis simulating a non-Langerhans cell histiocytosis, treated with tumour necrosis factor antagonists"]. An Pediatr (Barc) 2013; 78:281. [PMID: 23274149 DOI: 10.1016/j.anpedi.2012.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 11/12/2012] [Indexed: 11/15/2022] Open
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Petiti Martin G, Castellanos González M, Sanz Bueno J, Burgués Calderón M, Villar Buil M, Vanaclocha F, Peralto JL. [Misdiagnosed childhood sarcoidosis as non-Langerhans' cell histiocytosis treated with tumor necrosis factors-α antagonists]. An Pediatr (Barc) 2012; 77:267-71. [PMID: 22608978 DOI: 10.1016/j.anpedi.2012.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/18/2012] [Accepted: 01/21/2012] [Indexed: 11/19/2022] Open
Abstract
Sarcoidosis is a chronic multisystemic granulomatous disease of unknown origin. Generalised eruptive histiocytosis is a rare, benign, self-healing, non-Langerhans' cell histiocytosis (non-LCH). We report the case of an 8-year-old girl with sarcoidosis who was misdiagnosed as non-LCH. She was treated with oral corticosteroids, methotrexate and adalimumab, but there was insufficient control of ocular disease. The introduction of infliximab achieved a control of the uveitis and enabled the corticosteroid dose to be tapered. In some cases of sarcoidosis the lack of well-organised granuloma formation at the beginning of the disease, and the presence of prominent giant cells may suggest alternative diagnoses, such as non-LCH. Although the experience of tumour necrosis factor-α antagonists use in children with sarcoidosis is limited, these drugs may be helpful for those patients experiencing a severe and refractory disease.
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Affiliation(s)
- G Petiti Martin
- Servicio de Dermatología y Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, España.
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Affiliation(s)
- Yasuyuki Kamata
- Division of Rheumatology and Clinical Immunology, Jichi Medical University, Japan.
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Affiliation(s)
- Ying-Yi Lu
- Department of Dermatology, Kaohsiung Veterans General Hospital, Taiwan
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Krilis M, Miyakis S. Cytophagic histiocytic panniculitis with haemophagocytosis in a patient with familial multiple lipomatosis and review of the literature. Mod Rheumatol 2011; 22:158-62. [PMID: 21732050 DOI: 10.1007/s10165-011-0487-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 06/02/2011] [Indexed: 11/25/2022]
Abstract
We report a patient with the extremely rare familial multiple lipomatosis syndrome, who developed the uncommon autoimmune disease cytophagic histiocytic panniculitis, manifested as inflammation of preexisting lipomas. Despite his initial critical condition and unsuccessful treatment with steroids, he responded to cyclosporin and remains well 15 years after diagnosis. In contrast with most previous reports, our patient stays dependent on cyclosporin; repeated attempts of discontinuing or substituting treatment were quickly followed by relapse. Haemophagocytic panniculitis is considered as a T-cell disorder, but its exact pathophysiological mechanism has not been clarified. Differential diagnosis of cytophagic histiocytic panniculitis mainly includes malignant histiocytosis, subcutaneous panniculitis-like T-cell lymphoma (SPTCL) and lupus erythematosus panniculitis (lupus profundus). We discuss the main clinical features, diagnostic challenges and treatment issues of this usually benign, but at times life-threatening autoimmune condition.
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MESH Headings
- Cyclosporine/therapeutic use
- Diagnosis, Differential
- Family Health
- Female
- Genetic Predisposition to Disease
- Histiocytic Sarcoma/diagnosis
- Histiocytosis, Non-Langerhans-Cell/complications
- Histiocytosis, Non-Langerhans-Cell/diagnosis
- Histiocytosis, Non-Langerhans-Cell/drug therapy
- Humans
- Lipomatosis, Multiple Symmetrical/diagnosis
- Lipomatosis, Multiple Symmetrical/drug therapy
- Lipomatosis, Multiple Symmetrical/genetics
- Lymphohistiocytosis, Hemophagocytic/complications
- Lymphohistiocytosis, Hemophagocytic/diagnosis
- Lymphohistiocytosis, Hemophagocytic/drug therapy
- Lymphoma, T-Cell/diagnosis
- Male
- Panniculitis/complications
- Panniculitis/diagnosis
- Panniculitis/drug therapy
- Pedigree
- Treatment Outcome
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Affiliation(s)
- Matthew Krilis
- Department of Medicine, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia.
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Margolis S. Cutaneous xanthomatosis, diabetes insipidus, and hyperprolactinemia. Endocr Pract 2010; 16:933. [PMID: 20570806 DOI: 10.4158/ep10162.ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bialynicki-Birula R, Sebastian-Rusin A, Maj J, Wozniak Z, Baran E, Dziegiel P. Multicentric reticulohistiocytosis with S100 protein positive staining: a case report. Acta Dermatovenerol Croat 2010; 18:35-37. [PMID: 20361887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Multicentric reticulohistiocytosis is a very rare systemic disease that affects skin, mucosa and joints. We reported a case of a woman with multicentric reticulohistiocytosis who presented typical skin syndromes and arthralgia. Immunohistochemical analysis showed positive staining for S100 protein, which was reported negative in the majority of previously presented cases. Other immunohistochemical markers (CD68(+), CD1a(-), lagerin (-) and complete histologic and clinical picture were specific enough to make the definitive diagnosis of multicentric reticulohistiocytosis. The patient was administered prednisone just when arthritis appeared and we believe that this therapy protected her from the development of destructive arthritis. No autoimmune disease or internal malignancy was observed during 12-month follow up.
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Affiliation(s)
- Rafal Bialynicki-Birula
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, 50-368 Wroclaw, Poland.
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SantaLucia P, Helm MF. What is your diagnosis? Diagnosis: Multicentric reticulohistiocytosis with dermatomyositislike features. Cutis 2009; 84:246-273. [PMID: 20099616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Lee SH, Kim SD, Kim SH, Kim HR, Oh EJ, Yoon CH, Lee SH, Kim HY, Park SH. EBV‐associated haemophagocytic syndrome in a patient with Behçet's disease. Scand J Rheumatol 2009; 34:320-3. [PMID: 16195167 DOI: 10.1080/03009740510015186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We present a case of Epstein-Barr virus (EBV)-associated haemophagocytic syndrome in a patient with Behçet's disease. A 43-year-old man, who had been receiving treatment under the diagnosis of Behçet's disease for recurrent oral ulcers, genital ulcer, ileal ulcer, and arthritis, had been admitted for fever, headache, and nausea developed 3 days ago. Laboratory data showed pancytopaenia, an increase in liver enzymes, lactate dehydrogenase (LDH) and ferritin. Haemophagocytic syndrome was diagnosed from histiocytosis and haemophagocytosis by macrophages, shown in the bone marrow aspiration and biopsy, and in situ hybridization for EBV showed a positive finding. The patient recovered rapidly after steroid therapy. This is the first report of EBV-associated haemophagocytic syndrome developed in a patient with Behçet's disease.
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Affiliation(s)
- S-H Lee
- Department of Internal Medicine, Division of Rheumatology, Kangnam St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Mallo García S, Folgueras-Sánchez V, Santos-Juanes J. [Asymptomatic facial papules]. Actas Dermosifiliogr 2009; 100:149-150. [PMID: 19445882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Affiliation(s)
- Susana Mallo García
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, Asturias. España.
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Guerrero F, Roustan G, Tejerina E. [Single reticulohistiocytoma mimicking a keratoacanthoma]. Actas Dermosifiliogr 2008; 99:828-830. [PMID: 19091231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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Hinchman KF, Wu JJ, Soden CE, Waldman J, Dyson SW. Multicentric reticulohistiocytosis associated with Burkitt lymphoma and adenocarcinoma. Cutis 2008; 82:113-114. [PMID: 18792542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Multicentric reticulohistiocytosis (MRH) is a rare disease of unknown etiology characterized by cutaneous nodules and destructive, sometimes crippling, polyarthritis. The diagnosis is confirmed by histopathologic features of the cutaneous nodules or synovial tissue, including an infiltrate composed of histiocytes, many of them multinucleate, with a ground glass appearance. Multicentric reticulohistiocytosis has been associated with a number of chronic conditions and various malignancies. We report a case of MRH in a patient with Burkitt lymphoma and metastatic adenocarcinoma of the gastrointestinal tract.
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Benucci M, Sulla A, Manfredi M. Cardiac engagement in multicentric reticulohistiocytosis: report of a case with fatal outcome and literature review. Intern Emerg Med 2008; 3:165-8. [PMID: 18265939 DOI: 10.1007/s11739-008-0102-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Accepted: 01/18/2007] [Indexed: 10/22/2022]
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Caputo R, Marzano AV, Passoni E, Berti E. Unusual variants of non-Langerhans cell histiocytoses. J Am Acad Dermatol 2007; 57:1031-45. [PMID: 17485142 DOI: 10.1016/j.jaad.2007.03.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Revised: 01/31/2007] [Accepted: 03/06/2007] [Indexed: 11/23/2022]
Abstract
Histiocytic syndromes represent a large, heterogeneous group of diseases resulting from proliferation of histiocytes. In addition to the classic variants, the subset of non-Langerhans cell histiocytoses comprises rare entities that have more recently been described. These last include both forms that affect only the skin or the skin and mucous membranes, and usually show a benign clinical behavior, and forms involving also internal organs, which may follow an aggressive course. The goal of this review is to outline the clinical, histologic, and ultrastructural features and the course, prognosis, and management of these unusual histiocytic syndromes.
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Affiliation(s)
- Ruggero Caputo
- Institute of Dermatological Sciences, University of Milan-Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy
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Okabayashi T, Nishimori I, Kobayashi M, Sugimoto T, Kohsaki T, Okamoto K, Ito S, Moriki T, Araki K, Onishi S. Xanthogranulomatous pancreatic abscess secondary to acute pancreatitis: two case reports. Hepatogastroenterology 2007; 54:1648-1651. [PMID: 18019685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Xanthogranuloma is a rare type of inflammation and very few cases have been reported in the pancreas. We report two cases with xanthogranulomatous pancreatic abscess that followed acute pancreatitis. In both cases, multiple pseudocysts in the pancreatic tail were infected with several species of bacteria and Candida albicans. In one case, abdominal angiography revealed a hypoperfused pancreatic tail due to prior atherosclerotic obliteration of the celiac and superior mesenteric arteries. In the other case, the splenic artery was completely occluded by a transarterial embolization performed to treat an aneurysm that appeared in the course of pancreatitis. In both cases, distal pancreatectomy was performed as inflammation of the pancreatic tail was resistant to conventional antibiotic therapy, and pathologic examination revealed xanthogranulomatous inflammation around the pancreatic tail and spleen. Although the underlying pathogenesis is unclear, the prolonged infection and/or relative hypoxia induced by hypoperfusion are likely causative factors for the xanthogranulomatous changes in these pancreatic abscesses.
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Hansen K, Frikke M. Dual and discrepant case publication in regard to hemophagocytic lymphohistiocytosis and child abuse. Pediatr Radiol 2007; 37:846. [PMID: 17576549 DOI: 10.1007/s00247-007-0519-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2007] [Accepted: 04/30/2007] [Indexed: 11/26/2022]
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Utikal J, Ugurel S, Kurzen H, Erben P, Reiter A, Hochhaus A, Nebe T, Hildenbrand R, Haberkorn U, Goerdt S, Schadendorf D. Imatinib as a treatment option for systemic non-Langerhans cell histiocytoses. ACTA ACUST UNITED AC 2007; 143:736-40. [PMID: 17576939 DOI: 10.1001/archderm.143.6.736] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Systemic non-Langerhans cell histiocytoses are disorders characterized by the accumulation of histiocytes that do not meet the criteria for Langerhans cells in various organs. So far, no causative treatment is known. OBSERVATIONS Herein, we report the case of a 41-year-old man with Rosai-Dorfman disease, a form of systemic non-Langerhans cell histiocytoses, with histiocytic infiltrations in the skin, bone marrow, liver, and spleen. Histiocytes were positive for the imatinib target proteins platelet-derived growth factor receptor beta and KIT. The disease completely responded to treatment with 400 to 600 mg daily of imatinib for more than 7 months. CONCLUSION This case shows that imatinib is a powerful treatment option for patients with non-Langerhans cell histiocytoses.
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Affiliation(s)
- Jochen Utikal
- Department of Dermatology, Venereology, and Allergology, Central Laboratory, University Medical Center Mannheim, Ruprecht-Karl-University of Heidelberg, Germany.
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Luz FB, Gaspar NK, Gaspar AP, Carneiro S, Ramos-e-Silva M. Multicentric reticulohistiocytosis: a proliferation of macrophages with tropism for skin and joints, part I. Skinmed 2007; 6:172-8. [PMID: 17618169 DOI: 10.1111/j.1540-9740.2007.05810.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The authors present part I of a review of multicentric reticulohistiocytosis, a rare systemic proliferative disease of histiocytes of unknown cause. It is clinically characterized by cutaneous and mucosal nodules and by osteoarticular lesions. The disease occurs in outbreaks that progress in severity, with spontaneous regression, but usually leaving incapacitating arthritis and disfiguring facial lesions. The authors discuss the historical, epidemiologic, and clinical aspects of this disease.
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Affiliation(s)
- Flávio Barbosa Luz
- Sector of Dermatology, University Hospital HUCFF/UFRJ and School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Chauhan A, Mikulik Z, Hackshaw KV. Multicentric reticulohistiocytosis with positive anticyclic citrullinated antibodies. J Natl Med Assoc 2007; 99:678-80. [PMID: 17595939 PMCID: PMC2574375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This is a case report of a woman with multicentric reticulohistiocytosis with positive anticyclic citrullinated antibodies. This patient had been misdiagnosed with rheumatoid arthritis for many years. Recently, she presented with symmetric distal interphalangeal joint destruction and papules along her nail beds. Her clinical presentation, laboratory data, radiographic and histologic findings were all consistent with multicentric reticulohistiocytosis, not rheumatoid arthritis. This is the first case report of a patient with multicentric reticulohistiocytosis that tested positive for anticyclic citrullinated antibodies.
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Affiliation(s)
- Anupama Chauhan
- Division of Immunology/Rheumatology, William Davis Medical Research Center, The Ohio State University College of Medicine and Public Health, Columbus 43210-1228, USA.
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Abstract
Xanthogranulomatous orchitis is an extremely rare inflammatory non-neoplastic destructive lesion of the testis. We report a 44-year-old man who presented with right scrotal swelling and two discharging sinuses. Testicular tumor markers were normal. Scrotal ultrasound showed heterogeneous testicular areas and irregular margin of the tunica. Surgical exploration revealed infected, unhealthy testicular tissue with necrosis and tumor-like lesion. Orchidectomy was done and histopathology showed xanthogranulomatous orchitis.
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Affiliation(s)
- Sami Al-Said
- Urology Section, Hamad Medical Corporation, Doha, Qatar
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