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Hooda Z, Lu Y, Mehran RJ, Moran C, Barcenas CH. Rosai-Dorfman Disease Mimicking Metastasis to the Spleen From Breast Cancer. Clin Nucl Med 2025; 50:450-451. [PMID: 40179297 DOI: 10.1097/rlu.0000000000005796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2024] [Accepted: 01/23/2025] [Indexed: 04/05/2025]
Abstract
Rosai-Dorfman disease is a non-Langerhans cell histiocytosis with ubiquitous distribution. Although more common in lymph nodes, it has been described in many organ systems. The current case depicts a 54-year-old woman with a history of estrogen receptor-positive breast carcinoma who showed different image features of metastatic lymph nodes and splenic Rosai-Dorfman disease on FDG and FES PET/CT scans.
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Affiliation(s)
- Zamaan Hooda
- Department of Thoracic and Cardiovascular Surgery
| | - Yang Lu
- Department of Nuclear Medicine
| | | | | | - Carlos Hernando Barcenas
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX
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2
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Elzayat S, Morshedy A, El-Shirbeny HA, El-Rashidy MA, Barbara M, Covelli E, Khattab A, Lotfy A, Aouf MM, Elfarargy HH. Nasopharyngeal Representation of Rosai-Dorfman Disease; a Case Report. Indian J Otolaryngol Head Neck Surg 2025; 77:1871-1875. [PMID: 40226275 PMCID: PMC11985709 DOI: 10.1007/s12070-025-05389-5] [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: 09/12/2024] [Accepted: 02/07/2025] [Indexed: 04/15/2025] Open
Abstract
A 52-year-old female patient complaining of progressive nasal obstruction six months ago, nasopharyngoscopy revealed a nasopharyngeal large fleshy non-pulsatile mass, ear examination and tympanometry revealed left middle ear effusion without any abnormalities in mouth or oropharynx. There was no enlarged cervical lymphadenopathy in contrast to most RDD cases. Given clinical examination and radiological findings, an excisional biopsy was done under general anaesthesia with left ear ventilation T-tube insertion. Histopathological examination of the biopsy specimen reveals a unique histopathological feature, "emperipolesis", and immunohistochemistry confirmed the diagnosis of Rosai-Dorfman Disease.
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Affiliation(s)
- Saad Elzayat
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Ahmed Morshedy
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Hussein A. El-Shirbeny
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | | | - Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Ahmed Khattab
- Otorhinolaryngology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ashraf Lotfy
- Otorhinolaryngology Department, El-Galaa Military Hospital, Cairo, Egypt
| | - Mohammed M. Aouf
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Haitham H. Elfarargy
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
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3
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Marshall C, Marshall H. Unknown Case: Metastatic Breast Cancer With Abnormal Soft Tissue Mass in the Shoulder. JOURNAL OF BREAST IMAGING 2025; 7:119-121. [PMID: 38870255 DOI: 10.1093/jbi/wbae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Indexed: 06/15/2024]
Affiliation(s)
- Colin Marshall
- Department of Radiology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Holly Marshall
- Department of Radiology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Benson JC, Pais AB, Mark IT, Tobin WO, Chen JJ, Meyer FB, Hunt CH, Giannini C. Radiology-pathology correlation: Rosai-Dorfman disease. Neuroradiol J 2024:19714009241303077. [PMID: 39567877 PMCID: PMC11580121 DOI: 10.1177/19714009241303077] [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: 11/22/2024] Open
Abstract
Rosai-Dorfman Disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare non-Langerhans cell histiocytic neoplasm. Although the disease classically presents as massive painless lymphadenopathy in young adults, RDD can also involve the central nervous system in some patients. CNS lesions, can cause headaches, neurologic deficits, and even neurologic deficits. The imaging appearance of CNS RDD typically mimics that of meningiomas: well-circumscribed dural-based lesions that often have dural tails. However, some imaging clues also exist that might help a radiologist recognize RDD, even before histopathologic confirmation. This radiology-pathology report of a patient with CNS RDD highlights the most pertinent clinical, imaging, and pathologic features of CNS RDD, and discusses what the neuroradiologist needs to know about the disease.
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Affiliation(s)
- John C Benson
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Alex B Pais
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Ian T Mark
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - John J Chen
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA
| | - Frederic B Meyer
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Caterina Giannini
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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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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Qi W, Luo Z, Shao M, Chen M, Liao F, Hu L. Case report: A rare case of isolated sigmoid Rosai-Dorfman disease on contrast-enhanced CT and 18F-FDG PET/CT. Front Med (Lausanne) 2024; 11:1425112. [PMID: 38938381 PMCID: PMC11210213 DOI: 10.3389/fmed.2024.1425112] [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] [Received: 04/29/2024] [Accepted: 05/29/2024] [Indexed: 06/29/2024] Open
Abstract
Rosai-Dorfman disease (RDD) is an uncommon histiocytic disorder that occurs in nodal and/or extranodal sites. Extranodal RDD exhibits a wide range of clinical and radiological presentations, frequently leading to misdiagnoses. Involvement of the gastrointestinal (GI) system is uncommon, accounting for less than 1% of the reported cases. Here we present a case of a 54-year-old male who complained of abdominal distention and was diagnosed with RDD affecting the sigmoid colon, manifesting as a sigmoid mass. The patient had a past medical history of liver transplantation due to hepatocellular carcinoma (HC). This report details the multiphase contrast-enhanced computed tomography (CT) and fluorodeoxyglucose (18F-FDG) positron emission tomography (PET-CT) imaging findings of RDD involving the sigmoid colon without lymphadenopathy, and a review of the relevant literature is provided.
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Affiliation(s)
- Wanling Qi
- Department of Nuclear Medicine, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Zhehuang Luo
- Department of Nuclear Medicine, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Mingyan Shao
- Department of Nuclear Medicine, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Min Chen
- Department of Pathology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Fengxiang Liao
- Department of Nuclear Medicine, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Linfeng Hu
- Department of Pediatrics, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
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Lin Y, Wang F, Xu Q, Tian J. A case of intracranial and extracranial multiple Rosai-Dorfman diseases. Asian J Surg 2024; 47:2506-2507. [PMID: 38307795 DOI: 10.1016/j.asjsur.2024.01.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/19/2024] [Indexed: 02/04/2024] Open
Affiliation(s)
- Yuxin Lin
- Department of Radiology, the Second Hospital of Dalian Medical University, 467 Zhong Shan Road, Dalian 116023, People's Republic of China
| | - Fei Wang
- Department of Radiology, the Second Hospital of Dalian Medical University, 467 Zhong Shan Road, Dalian 116023, People's Republic of China
| | - Qiushi Xu
- Department of Neurosurgery, Central Hospital of Dalian University of Technology, 826 Southwest Road, Dalian 116083, People's Republic of China.
| | - Juan Tian
- Department of Radiology, the Second Hospital of Dalian Medical University, 467 Zhong Shan Road, Dalian 116023, People's Republic of China.
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Zhang W, Fang L, Wang J, Ma X, Hu X, Liu W. Mediastinal Rosai-Dorfman Disease with KRAS mutation case report and literature review. J Cardiothorac Surg 2024; 19:166. [PMID: 38561747 PMCID: PMC10985954 DOI: 10.1186/s13019-024-02668-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Rosai-Dorfman Disease (RDD) is a rare self-limiting histiocytosis, more prevalent in children and young adults. It typically manifests as painless bilateral massive cervical lymphadenopathy but may also extend to extra-nodal sites, with intrathoracic RDD noted in 2% of cases. Distinguishing mediastinal RDD from thymoma on imaging poses challenges, underscoring the reliance on pathological features and immunohistochemical staining for diagnosis. CASE PRESENTATION Patient, male, 33 years old, underwent lung a CT revealing an enlarged round soft tissue shadow in the anterior superior mediastinum, compared to a year ago. Surgical resection removed the entire mass, thymus, and part of the pericardium, confirming RDD on pathology. Genetic testing using second-generation testing technology identified a KRAS gene point mutation. CONCLUSIONS No established treatment protocol currently exists for this disease. However, as genetic mutation research progresses, a novel therapeutic avenue is emerging: targeted therapy integrated with surgical interventions.
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Affiliation(s)
- Wenyu Zhang
- Department of Thoracic Surgery, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Linan Fang
- Department of Thoracic Surgery, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Jing Wang
- Department of Radiology, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiaobo Ma
- Department of Pathology, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Xintong Hu
- Genetic Diagnosis Center, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Liu
- Department of Thoracic Surgery, the First Hospital of Jilin University, Changchun, Jilin, China.
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Agarwal A, Ravindran A, Donahue J, Eltoum IE, Abozeed M. Extranodal Rosai-Dorfman Disease: a rare presentation involving anterior chest wall in a middle-aged female. Skeletal Radiol 2024; 53:589-594. [PMID: 37603054 DOI: 10.1007/s00256-023-04427-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/27/2023] [Accepted: 08/06/2023] [Indexed: 08/22/2023]
Abstract
Rosai-Dorfman Disease is a rare benign disorder involving overproduction of immune cells, causing swollen lymph nodes and, in rare cases, the sternum. The sternal involvement may cause chest pain and masses. Diagnosis is confirmed through clinical examination, biopsy, and imaging. Treatment options may include surgery, radiation, or steroids. In this case study, we present an unusual example of extranodal Rosai-Dorfman Disease involving the sternum, bilateral clavicles and first three ribs, and pectoral muscle with no associated lymphadenopathy or systemic symptoms in a 57-year-old female. The etiology, pathology, immunohistochemistry, imaging findings, and treatment options of this unique disease are discussed.
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Affiliation(s)
| | - Aishwarya Ravindran
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Clinical Pathology Department, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - James Donahue
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Thoracic Surgery Department, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Isam-Eldin Eltoum
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Clinical Pathology Department, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Mostafa Abozeed
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
- Radiology Department, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
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Zheng J, Wang J, Chen W, Fan W, Xu J. Intracranial Rosai-Dorfman disease: a case report and review of the literature. Neurol Sci 2023; 44:3675-3678. [PMID: 37566197 DOI: 10.1007/s10072-023-06986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/22/2023] [Indexed: 08/12/2023]
Abstract
RDD involving the central nervous system is rarely reported. To better understand the disease and explore the treatments, we reported this case and review the literature.
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Affiliation(s)
- Jia Zheng
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jihu Wang
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Weiqiang Chen
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Wenyong Fan
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jiajun Xu
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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Njoum Y, Abu-Hilal LH, Jabbarin F, Bannoura S, Mtour S, Itmaizeh M. Rosai-Dorfman disease presenting as autoimmune hemolytic anemia in a male child in Palestine: a case report. Oxf Med Case Reports 2023; 2023:omad078. [PMID: 37484548 PMCID: PMC10359060 DOI: 10.1093/omcr/omad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare, benign non-Langerhans cell histiocytosis predominantly affects lymph nodes and skin. Despite its benign nature, RDD can cause serious hematological complications. A 14-year-old male, presented with 3-month history of hemolytic anemia, lymphadenopathy, hepatosplenomegaly and rash. After thorough investigation, RDD was diagnosed by mediastinal lymph node biopsy that revealed presence of S100 and CD68-positive cells with absence of CD1a confirming the diagnosis of RDD. Treatment involved combination of steroids and Rituximab, which proved to be highly effective. The patient had dramatic improvement and entered remission, with follow-up period of 2 years. It is important to note that although RDD is a rare disease, it causes severe complications, as evidenced by the patient's parameters. Thus, prompt diagnosis and treatment are paramount. Histological diagnosis is of great value, as it helps confirming and guiding treatment decisions. With the right treatment, patients can experience great recovery and quality of life.
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Affiliation(s)
- Yumna Njoum
- Correspondence address. Faculty of Medicine, Al-Quds University, West Bank, PO: P583, Palestine. Tel: +972592130424; E-mail:
| | | | - Farah Jabbarin
- Department of Cardiology, Al-Makassed Hospital, Jerusalem, Palestine
| | - Sami Bannoura
- Department of Pathology, Al-Makassed Hospital, Jerusalem, Palestine
| | - Sameer Mtour
- Department of Cardiology, Al-Makassed Hospital, Jerusalem, Palestine
| | - Muaath Itmaizeh
- Department of Rheumatology, Al-Makassed Hospital, Jerusalem, Palestine
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