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Zhang GJ, Ma XJ, Zhang YP, Hao LF, Wang L, Zhang JT, Wu Z, Li D. Surgical management and outcome of primary intracranial Rosai-Dorfman disease: a single-institute experience and pooled analysis of individual patient data. Neurosurg Rev 2023; 46:76. [PMID: 36967440 DOI: 10.1007/s10143-023-01983-9] [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: 07/05/2022] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
Primary intracranial Rosai-Dorfman disease (PIRDD) is considered a nonmalignant nonneoplastic entity, and the outcome is unclear due to its rarity. The study aimed to elaborate the clinic-radiological features, treatment strategies, and progression-free survival (PFS) in patients with PIRDD. Patients with pathologically confirmed PIRDD in our institute were reviewed. Literature of PIRDD, updated until December 2019, was systematically searched in 7 databases (Embase, PubMed, Cochrane database, Web of Science, Wanfang Data Knowledge Service Platform, the VIP Chinese Science and Technology Periodical Database (VIP), and the China National Knowledge Infrastructure (CNKI)). These prior publication data were processed and used according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Clinical-radiological characteristics and adverse factors for PFS were evaluated in the pooled cohort. The pooled cohort of 124 cases (81 male and 43 female), with a mean age of 39.7 years, included 11 cases from our cohort and 113 cases from 80 prior studies. Twenty-nine patients (23.4%) had multiple lesions. Seventy-four patients (59.7%) experienced gross total resection (GTR), 50 patients (40.3%) had non-GTR, 15 patients (12.1%) received postoperative adjuvant radiation, and 23 patients (18.5%) received postoperative steroids. A multivariate Cox regression revealed that GTR (HR = 4.52; 95% CI 1.21-16.86; p = 0.025) significantly improved PFS, and multiple lesions (p = 0.060) tended to increase the hazard of recurrence. Neither radiation (p = 0.258) nor steroids (p = 0.386) were associated with PFS. The overall PFS at 3, 5, and 10 years in the pooled cohort was 88.4%, 79.4%, and 70.6%, respectively. The PFS at 5 and 10 years in patients with GTR was 85.4% and 85.4%, respectively, which was 71.5% and 35.8%, respectively, in patients without GTR. Gross total resection significantly improved PFS and was recommended for PIRDD. Radiation and steroids were sometimes empirically administered for residual, multiple, or recurrent PIRDD, but the effectiveness remained arguable and required further investigation.Systematic review registration number: CRD42020151294.
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Affiliation(s)
- Gui-Jun Zhang
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiu-Jian Ma
- Division of Molecular Neurogenetics, German Cancer Research Center (DKFZ), DKFZ-ZMBH Alliance, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Ya-Ping Zhang
- Head and Neck Surgery Center, Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Li-Fang Hao
- Department of Radiology, Liao Cheng The Third People's Hospital, Liaocheng, China
| | - Liang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Nansihuanxilu 119, Fengtai District, Beijing, China
| | - Jun-Ting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Nansihuanxilu 119, Fengtai District, Beijing, China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Nansihuanxilu 119, Fengtai District, Beijing, China
| | - Da Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Nansihuanxilu 119, Fengtai District, Beijing, China.
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Magableh HM, Jaber HD, Magableh AM, Alrabiah MA, Dahhan AF, Azzam AZ, Amin T. Rosai-Dorfman Disease: Case Series and Literature Review. Cureus 2023; 15:e35193. [PMID: 36960255 PMCID: PMC10030647 DOI: 10.7759/cureus.35193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 02/22/2023] Open
Abstract
Rosai-Dorfman Disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is an uncommon histiocytic condition characterized by massive histopathological aggregation of CD1-a negative, CD68-positive, and S100-positive histiocytes. It was initially described by Destombes in 1965 under the term "adenitis with lipid excess." However, it is named after Rosai and Dorfman who reported further histopathological features of the disease in 1969. The diagnosis of this non-Langerhans cell histiocytosis can be challenging and requires high clinical suspicion. The diagnostic process usually involves imaging, tissue biopsies, and genetic testing as needed. In this case series, we are presenting three cases of rare disease. Case 2 had both nodal and extranodal forms, which makes this case rarer than cases 1 and 3, which present with extranodal lesions.
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Affiliation(s)
| | - Hamzh D Jaber
- College of Medicine, Alfaisal University, Riyadh, SAU
| | | | | | | | - Ayman Z Azzam
- Department of Surgical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
- Department of General Surgery, Faculty of Medicine, Alexandria University, Alexandria, EGY
| | - Tarek Amin
- Department of Surgical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
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Jamali E, Sharifi G, Ghafouri-Fard S, Bidari Zerehpoosh F, Yazdanpanahi M, Taheri M. Intracranial Rosai Dorfman Disease Presented With Multiple Huge Intraventricular Masses: A Case Report. Front Surg 2022; 9:766840. [PMID: 35388367 PMCID: PMC8977648 DOI: 10.3389/fsurg.2022.766840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/14/2022] [Indexed: 12/12/2022] Open
Abstract
IntroductionRosai-Dorfman disease (RDD) usually presents with painless cervical lymphadenopathy during the two first decades of life, with or without extranodal involvement. Exclusive extranodal manifestation, and especially central nervous system (CNS) involvement, is uncommon. The etiology remains unknown and definitive diagnosis is based on characteristic histopathological and immunohistochemical features showing S100(+) CD1a(−) RDD type histiocytes with emperipolesis. Most CNS cases are dural-based masses.Case PresentationHerein, we present a case of RDD in an 8-year-old boy, who presented with multiple huge intraventricular masses.ConclusionRegarding rare CNS involvement and lack of established evidence-based therapeutic approaches, reports of any individual case can supply further beneficial data concerning treatment approaches and long-term effectiveness of therapeutic strategies.
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Affiliation(s)
- Elena Jamali
- Department of Pathology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Guive Sharifi
- Department of Pathology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Guive Sharifi
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farahnaz Bidari Zerehpoosh
- Department of Pathology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmood Yazdanpanahi
- Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Mohammad Taheri
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tatit RT, Raffa PEAZ, de Almeida Motta GC, Bocchi AA, Guimaraes JL, Franceschini PR, de Aguiar PHP. Rosai-Dorfman disease mimicking images of meningiomas: Two case reports and literature review. Surg Neurol Int 2021; 12:292. [PMID: 34221623 PMCID: PMC8247728 DOI: 10.25259/sni_918_2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/11/2021] [Indexed: 11/05/2022] Open
Abstract
Background: Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytic proliferative disorder classically as a massive cervical lymphadenopathy. However, over the years, extranodal locations were confirmed with the central nervous system involvement in less than 5% of cases, which is marked as a significant differential diagnosis of meningiomas, with which they are widely confused due to the similarity of their radiological images. Case Description: We report a 37-year-old man and 45-year-old man who were diagnosed with intracranial RDD but whose radiological images mimic meningiomas, requiring anatomopathological and tumor’s immunohistochemistry for definitive diagnosis. Moreover, a review of 184 publications with 285 cases of intracranial involvement of this disease was also performed, comparing these findings with those brought in the previous studies. Conclusion: Intracranial Rosai-Dorfman tumors should always be remembered as differential diagnosis of meningiomas since they are similar radiologically and macroscopically. Once remembered and diagnosed, the lesion must be treated following the same pattern of resection done in meningiomas and, treatment’s differences will not occur in the surgical excision technique, but in complementary chemotherapy implementation, radiotherapy, and even with radiosurgery aid, depending on the case. Thus, it is possible to obtain better results than with just the isolated surgical procedure.
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Affiliation(s)
- Rafael Trindade Tatit
- Department of Medicine, Albert Einstein Israeli Faculty of Health Sciences, São Paulo, Brazil
| | | | | | | | - Júlia Loripe Guimaraes
- Department of Medicine, Albert Einstein Israeli Faculty of Health Sciences, São Paulo, Brazil
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Hu PP, Wei F, Liu XG, Liu ZJ. Diagnosis and treatment of Rosai-Dorfman disease of the spine: a systematic literature review. Syst Rev 2021; 10:31. [PMID: 33461611 PMCID: PMC7814441 DOI: 10.1186/s13643-021-01581-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/02/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To review and summarize the clinical features, diagnosis, treatment strategies, and prognosis of spinal Rosai-Dorfman disease (RDD). METHODS RDD is also termed as sinus histiocytosis with massive lymphadenopathy. We searched the databases of PubMed, Elsevier ScienceDirect, SpringerLink, and OVID. The keywords were Rosai-Dorfman disease and spine/central nervous system. Research articles and case reports with accessibility to full texts regarding spinal RDD were eligible for the inclusion. A total of 62 articles were included, and they contained 69 cases. We extracted the information of interest and analyzed them using SPSS statistics package. RESULTS The average age was 33.1 ± 18.3 years. The ratio of males to females was 1.9/1. Overall, 63 cases presented with spine-related symptoms. A total of 27 cases (39.1%) had multi-organ lesions, and 12 cases had records of massive lymphadenopathy. Among 47 cases who first manifested spine-related symptoms, 93.6% were preoperatively misdiagnosed. The disease had a predilection for cervical spine (38.8%) and thoracic spine (40.3%). 62.9% of lesions were dura-based. Surgery remained the mainstream treatment option (78.8%), with or without adjuvant therapies. Total lesion resection was achieved in 34.8% of cases. The rate of lesion recurrence/progression was 19.5%, which was marginally lower for total resection than for non-total resection. CONCLUSION Spinal RDD has no pathognomonic clinical and imaging features. Most cases first present with spine-relevant symptoms. Massive lymphadenopathy is not common, but a tendency for multi-organ involvement should be considered. Spinal RDD has a high recurrence rate; thus, total resection is the treatment of choice. Adjuvant therapies are indicated for multi-organ lesions and residual lesions. A wait and watch strategy is recommended for asymptomatic patients. Herein, a workflow of diagnosis and treatment of the spinal RDD is established.
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Affiliation(s)
- Pan-Pan Hu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Feng Wei
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China.
| | - Xiao-Guang Liu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Zhong-Jun Liu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China
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Riccio L, Donofrio CA, Serio G, Melatini A. Malignant behaviour of primary intracranial Rosai Dorfman disease: A rare presentation of a benign disease. Neurochirurgie 2020; 67:205-209. [PMID: 33276004 DOI: 10.1016/j.neuchi.2020.11.006] [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: 07/20/2020] [Revised: 10/04/2020] [Accepted: 11/21/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The Rosai Dorfman disease (RDD) is a rare and usually benign lymphoproliferative disorder of unknown aetiology, typically characterized by head and neck lymphadenopathies. However, it may occasionally present with primary extra-nodal involvement including the central nervous system. We firstly described the potential malignant behaviour and fatal evolution of primary intracranial RDD. ILLUSTRATIVE CASE A 69-year-old woman sought clinical attention for recurrent episodes of headache, fever and malaise associated with bilateral proptosis and left lower limb paresis. The brain MRI revealed bilateral retro-bulbar and fronto-parieto-occipital subdural lesions. The body CT did not show extracranial lesions. A right fronto-parietal craniotomy was performed and a subtotal resection was achieved. The histopathological diagnosis was consistent with RDD. Despite the patient was commenced on high-dose corticosteroids, she developed a worsening respiratory distress syndrome and a rapid systemic disease progression with liver and kidney failure. Given the poor general status, adjuvant medical and radiation therapies were not deemed safe and feasible and the patient died of multi-organ failure a month later. CONCLUSIONS We documented an exceptional case of primary intracranial RDD with malignant behaviour characterized by rapid systemic disease progression and poor prognosis. Although RDD with intracranial location has usually a benign and self-limiting course with good response to adjuvant treatments, it hides a malignant potential that may lead patients to death.
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Affiliation(s)
- L Riccio
- Department of Neurosurgery, Ospedale 'Vito Fazzi', Piazza F. Muratore 1, 73100, Lecce, Italy; Vita-Salute San Raffaele University, Milan, Italy.
| | - C A Donofrio
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - G Serio
- Department of Pathology, Ospedale 'Vito Fazzi', Lecce, Italy
| | - A Melatini
- Department of Neurosurgery, Ospedale 'Vito Fazzi', Piazza F. Muratore 1, 73100, Lecce, Italy
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Report of isolated epidural extra-nodal Rosai-Dorfman disease of cervicothoracic spine. Spinal Cord Ser Cases 2020; 6:82. [PMID: 32855389 DOI: 10.1038/s41394-020-00332-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy is a nonneoplastic lymphoproliferative disorder which commonly presents with painless massive cervical lymphadenopathy along with fever and weight loss. Isolated extra-nodal disease involvement, especially isolated central nervous system disease without lymph node involvement is rare. CASE PRESENTATION A 35-year-old man presented with upper back pain and paraparesis of 2 months duration. Contrast-MRI revealed an enhancing epidural mass lesion from C6-T7 suggestive of a primary epidural spinal-cord tumor. The lesion was resected and posterolateral fusion C6-T8 was performed. Histopathological examination revealed an isolated extra-nodal case of RDD. He was started on chemotherapy after the healing of surgical site in 2 weeks post operatively. Complete resolution of neurological deficits with significant improvement in gait was seen at the last follow-up 2 years after surgery. Repeat MRI revealed complete resolution of the disease. DISCUSSION RDD with spinal involvement is rare and it is often a challenge to arrive at the correct diagnosis. Histopathological characteristics and immunohistochemical findings are necessary for diagnosis. Resection of the lesion takes compression off the cord and therefore, is the primary line of management of this disease. Our case presentation serves as a reference when diagnosing and managing a patient of RDD.
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Baassiri W, Moussalem CK, Massaad E, Zeidan YH, Darwish H. Craniocervical Rosai-Dorfman Disease Involving the Vertebral Artery: Case Report and Literature Review. World Neurosurg 2019; 133:69-73. [PMID: 31550540 DOI: 10.1016/j.wneu.2019.09.072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/14/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare non-Langerhans cell reactive histiocytic disorder that rarely occurs in the central nervous system (CNS). Extranodal RDD most frequently involves the skin, upper respiratory tract, soft tissue, gastrointestinal tracts, bones, breast, and CNS. CASE DESCRIPTION RDD of the CNS infiltrates most commonly the dura of the sella, cavernous sinus, and the periclival regions. It is usually clinically and radiologically mistaken for meningioma because of its focal dural-based aspect. RDD is confirmed histologically by lymphoplasmacytic cells and histiocytes of varying size showing emperipolesis (lymphocytophagocytosis). To date, only 4 cases of RDD displaying spinal cord compression secondary to craniocervical junction involvement have been reported. CONCLUSION We report the case of a patient diagnosed with RDD localized at the foramen magnum extending to the base of the odontoid process and involving the V4 segment vertebral artery.
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Affiliation(s)
- Wassim Baassiri
- Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Charbel K Moussalem
- Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Elie Massaad
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Youssef H Zeidan
- Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Houssein Darwish
- Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
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Li Z, Zhou C, Chen G, Bao Y. Intracranial Rosai-Dorfman Disease Involving the Cavernous Sinus: A Case Report and Review of the Literature. World Neurosurg 2018; 119:249-255. [DOI: 10.1016/j.wneu.2018.08.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 10/28/2022]
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Cheng X, Cheng JL, Gao AK. A Study on Clinical Characteristics and Magnetic Resonance Imaging Manifestations on Systemic Rosai-Dorfman Disease. Chin Med J (Engl) 2018; 131:440-447. [PMID: 29451149 PMCID: PMC5830829 DOI: 10.4103/0366-6999.225053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: Rosai-Dorfman disease (RDD) is typically characterized by painless bilateral and symmetrical cervical lymphadenopathy, with associated fever and leukocytosis. The aim of the current study was to summarize the clinical features and imaging characteristics of RDD, in an effort to improve its diagnostic accuracy. Methods The study was analyzed from 32 patients between January 2011 and December 2017; of these, 16 patients had pathologically diagnosed RDD, eight had pathologically diagnosed meningioma, and eight pathologically diagnosed lymphoma. All patients underwent computed tomography and magnetic resonance imaging (MRI). Clinical features and imaging characteristics of RDD were analyzed retrospectively. The mean apparent diffusion coefficient (ADC) values of lesions at different sites were measured, and one-way analysis of variance and the least significant difference t-test were used to compare the differences between groups and draw receiver operating characteristic curves. The tumors were excised for biopsy and analyzed using immunohistochemistry. Results: The mean ADCs were (0.81 ± 0.10) × 10-3 mm2/s for intercranial RDD, (0.73 ± 0.05) × 10-3 mm2/s for nasopharyngeal RDD, (0.74 ± 0.11) × 10-3 mm2/s for bone RDD, and (0.71 ± 0.04) × 10-3 mm2/s for soft-tissue RDD. The optimum ADC to distinguish intracranial RDD from lymphoma was 0.79 × 10-3 mm2/s (62.5% sensitivity and 100% specificity) and to distinguish meningioma from intracranial RDD was 0.92 × 10-3 mm2/s (62.5% sensitivity and 100% specificity). Levels of C-reactive protein, erythrocyte sediment rate and D-dimer were significantly elevated (81%, 87%, and 75%, respectively). On immunohistochemistry, RDD was positive for both S-100 and CD68 proteins but negative for CD1a. Conclusions: Conventional MRI, combined with diffusion-weighted imaging and ADC mapping, is an important diagnostic tool in evaluating RDD patients. An accurate diagnosis of RDD should consider the clinical features, imaging characteristics, and the pathological findings.
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Affiliation(s)
- Xiao Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Jing-Liang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - An-Kang Gao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
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Baldi I, Belcastro M, Rossi M, Rossi A, Minacci C, Natale A. Rosai-Dorfman Disease Presenting as Peripheral Vascular Insufficiency. Ann Vasc Surg 2018; 53:267.e5-267.e9. [PMID: 30012448 DOI: 10.1016/j.avsg.2018.05.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 04/21/2018] [Accepted: 05/06/2018] [Indexed: 11/16/2022]
Abstract
Rosai-Dorfman (-Destombes) disease (RDDD) is a rare idiopathic disorder of histiocyte proliferation, usually involving lymph node stations. The most common clinical finding is a bilateral cervical lymphadenopathy, fever, and weight loss. Arterial or venous structures are notably not involved. We hereby present a case of a 78-year-old Caucasian man, presenting with symptoms of progressive arterial insufficiency and right lower-limb edema, along with a nonpulsatile mass at the middle third of the thigh. Initial diagnostic hypothesis was a superficial femoral artery aneurysm thrombosis with a secondary postcompressive superficial femoral vein thrombosis. Duplex examination showed right superficial femoral arterial and venous thrombosis, along with a hypoechogenic mass causing compression of the neurovascular bundle. Suspecting a connective tissue sarcoma, computed tomography scan was performed after combined en bloc removal of the mass along with femoral artery and vein and prosthetic reconstruction of vascular continuity. Histopathology diagnosis was connective tissue RDDD. The atypical presentation of this rare syndrome induces us to include in differential diagnosis, among other more common forms of external compression of the neurovascular bundles, even rare conditions such as these, which generally only involve lymphatic stations.
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Affiliation(s)
- Irene Baldi
- Vascular Surgery Unit, Misericordia Hospital, Grosseto, Italy
| | - Mirko Belcastro
- Vascular Surgery Unit, Misericordia Hospital, Grosseto, Italy.
| | - Maja Rossi
- Molecular Biology Laboratory- Clinical Pathology Unit, Misericordia Hospital, Grosseto, Italy
| | - Armando Rossi
- Pathology Unit, Misericordia Hospital, Grosseto, Italy
| | | | - Armando Natale
- Vascular Surgery Unit, Misericordia Hospital, Grosseto, Italy
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Zhang S, Huang J, Chen Y. Primary isolated intracranial Rosai–Dorfman disease: Report of a rare case and review of the literature. Neurol Neurochir Pol 2018; 52:390-393. [DOI: 10.1016/j.pjnns.2017.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 12/19/2017] [Indexed: 11/30/2022]
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Tan S, Ruan L, Jin K, Wang F, Mou J, Huang H, Yang G. Systemic Rosai-Dorfman disease with central nervous system involvement. Int J Neurosci 2017; 128:192-197. [PMID: 28881164 DOI: 10.1080/00207454.2017.1377709] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Rosai-Dorfman disease (RDD) is a rare idiopathic and lymphoproliferative disorder. Central nervous system (CNS) involvement is infrequent and typically manifests as an isolated lesion. In this article, we describe an unusual case of RDD with multiple lesions in the CNS, upper respiratory tract and lymph nodes. A literature review revealed 45 cases (including the one described herein) of systemic RDD with CNS involvement documented to date. Among these cases, 29 (64.4%) presented with intracranial lesions, 10 (22.2%) with spinal lesions and 6 (13.3%) with both. While the condition of most patients was stable, only four died from RDD or for other reasons. Prognosis is good for most patients, even those with extensive lesions. Although there are various treatments for RDD, surgery is preferred. Given the rarity of RDD, multicenter international collaborations are advocated in order to study disease pathogenesis and develop effective treatment strategies.
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Affiliation(s)
- Song Tan
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Lunliang Ruan
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Kai Jin
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Fuchao Wang
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Jiamin Mou
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Hua Huang
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Gang Yang
- a Department of Neurosurgery , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
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Joshi SS, Joshi S, Muzumdar G, Turel KE, Shah RM, Ammbulkar I, Hussain MM, Choudhari KA. Cranio-spinal Rosai Dorfman disease: case series and literature review. Br J Neurosurg 2017; 33:176-183. [PMID: 28532172 DOI: 10.1080/02688697.2017.1329517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Rosai-Dorfman disease (RDD) is a rare condition similar to lymphomas, presenting with cervical lymphadenopathy in young adults. Extra-nodal involvement is relatively common but involvement of the central nervous system (CNS) is rare. Cranial RDD presents with symptoms of raised intracranial pressure, focal or generalised seizures, while spinal RDD presents with pain, peripheral neurological deficits and radiculopathy. In contrast to other similar neoplastic or degenerative conditions affecting the CNS, RDD is a benign, non-infective, granulomatous disorder. Radiologically cranio-spinal RDD often mimics commoner dural-based lesions like meningioma, with only subtle radiological differentiating findings on Magnetic Resonance Imaging (MRI). The histopathology of RDD is diagnostic. Surgical excision is preferred modality of treatment. However, adjuvant therapies like steroids and radiation may help controlling residual or recurrent disease. There are multiple sporadic reports and short case publications in the literature, often focusing on a particular aspect of RDD. In this study, authors aim to present five cases of craniospinal RDD, and comprehensive review of literature and highlight neurological complications of systemic RDD.
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Affiliation(s)
- Shashank S Joshi
- a Department of Neurosurgery , Hindu Rhiday Samrat Balasaheb Thakare Medical College & Dr R N Cooper Hospital , Mumbai , Maharashtra , India.,b Department of Neurosurgery , Sevenhills Hospital , Mumbai , Maharashtra , India
| | - Shilpa Joshi
- c Department of CT and MRI , Fortis Hospitals , Mumbai , Maharashtra , India
| | - Girish Muzumdar
- d Department of Histopathology , Bombay Hospital Institute of Medical Sciences , Mumbai , Maharashtra , India
| | - Keki E Turel
- e Department of Neurosurgery , Bombay Hospital Institute of Medical Sciences , Mumbai , Maharashtra , India
| | - Rajan M Shah
- b Department of Neurosurgery , Sevenhills Hospital , Mumbai , Maharashtra , India.,e Department of Neurosurgery , Bombay Hospital Institute of Medical Sciences , Mumbai , Maharashtra , India
| | - Indoo Ammbulkar
- f Department of Medical Oncology , Sevenhills Hospital , Mumbai , Maharashtra , India
| | | | - Kishor A Choudhari
- h Department of Neurosurgery , Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust , Sheffield , UK
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Tu J, Li WT, Yang C. Rosai-Dorfman disease of the subdural spine with a long segment lesion: A case report and literature review. J Int Med Res 2017; 45:875-881. [PMID: 28173721 PMCID: PMC5536658 DOI: 10.1177/0300060516687228] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy is a rare benign disorder usually characterized by massive painless cervical lymphadenopathy and systemic manifestations. Extranodal involvement, especially spinal involvement, is extremely rare. We report a 41-year-old man who presented with only intermittent dorsodynia. His condition was diagnosed as non-specific inflammatory disease on the basis of preoperative puncture biopsy results. We performed total surgical resection. Histopathological findings showed distinctive emperipolesis and immunohistochemistry results were positive for cluster of differentiation CD68 and S100 and negative for CD1a. A good prognosis was confirmed at the 3-month follow-up visit. This is the first case of RDD of the subdural spine with such a long segment lesion. There is still no consensus regarding appropriate therapy for this type of RDD and the preoperative diagnosis remains challenging. The unusual presentation of our case serves as a reference when diagnosing and treating RDD.
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Affiliation(s)
- Ji Tu
- 1 Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Wen-Tian Li
- 2 Wuhan Institute of Biological Products Co. limited, Wuhan, Hubei Province, China
| | - Cao Yang
- 1 Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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16
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99mTc-Sestamibi Avid Soft Tissue Lesions in Rosai-Dorfman Disease. Clin Nucl Med 2016; 41:e508-e510. [PMID: 27824326 DOI: 10.1097/rlu.0000000000001380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Langerhan's histiocytosis is a not uncommon disease, but a related disorder, Rosai-Dorfman (RDD) with extensive or exclusive extranodal distribution, is relatively rare. Ga and PET/CT imaging have typically been used for diagnosis and tracking response to treatment. The authors present a very unusual case wherein lesions of RDD actively accumulated Tc-sestamibi, which was injected as part of a scan to localize a parathyroid adenoma.
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Huang BY, Zong M, Zong WJ, Sun YH, Zhang H, Zhang HB. Intracranial Rosai-Dorfman disease. J Clin Neurosci 2016; 32:133-6. [PMID: 27561856 DOI: 10.1016/j.jocn.2015.12.046] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 12/19/2015] [Accepted: 12/29/2015] [Indexed: 12/30/2022]
Abstract
Rosai-Dorfman disease (RDD) is a rare histioproliferative disorder that only occasionally involves the central nervous system. We present the diagnosis and treatment of five patients with intracranial RDD. The patients were preoperatively misdiagnosed as meningioma or eosinophilic granuloma. All five patients were treated by total or subtotal surgical resection and none of them experienced recurrence. Histopathological examination showed a characteristic emperipolesis, the lymphocytes were engulfed in the S-100 protein and CD68 positive histiocytes, with negative expression of CD1a. Preoperative diagnosis of intracranial RDD is still challenging because the lesion is usually a dural-based lesion that mimics a meningioma. Surgical resection is an effective treatment and radiotherapy, steroid and chemotherapy has not demonstrated reliable therapeutic efficiency.
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Affiliation(s)
- Bo Yuan Huang
- Department of Neurosurgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China
| | - Miao Zong
- Department of Neurosurgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China
| | - Wen Jing Zong
- College of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yan Hui Sun
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
| | - Hua Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Hong Bo Zhang
- Integrated Traditional and Western Medicine Hospital of Hubei Province, Department of Neurosurgery, Wu Han, China
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18
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Rosai-Dorfman disease involving the central nervous system: seven cases from one institute. Acta Neurochir (Wien) 2015. [PMID: 26210482 DOI: 10.1007/s00701-015-2511-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Rosai-Dorfman disease (RDD) is a rare, idiopathic, non-neoplastic histioproliferative disease. Central nervous system (CNS) manifestations are extremely rare. Its low incidence and unknown etiology restrict early diagnosis and optimal therapy. METHODS In the 1995-2013 period, seven CNS-RDD patients with intracranial and/or spinal lesions were retrospectively analyzed, including the clinical data, laboratory and imaging results, treatment applied and outcome. All seven case samples were screened for the SLC29A3 gene mutation, and the literature was reviewed. RESULTS Seven RDD patients (6 male/1 female, aged between 7 and 68) with CNS manifestations are reported. Five of the seven patients (71.4 %) had intracranial lesions (1 with skull erosion and 1 with multiple lesions mimicking meningiomas), and two (28.6 %) had spinal subdural lesions. The patients' symptoms included headaches, seizures, visual loss, epileptoid convulsions in the lower legs, fever, spastic paraparesis and paraplegia. An elevated erythrocyte sedimentation rate (ESR) was detected in five of the seven cases. The diagnosis was confirmed by immunohistochemical staining revealing that the characteristic histiocytes were positive for the S100 protein and CD68 and negative for CD1a. All patients were operated on: three recovered completely, two were partially rehabilitated, and two died. No SLC29A3 gene mutations were found in any of the seven samples. CONCLUSION This short series suggests the following: (1) RDD should be included in the differential diagnosis of lesions mimicking intracranial/spinal meningiomas or inflammatory lesions, especially in children; (2) the definitive diagnosis is based on histopathology and immunocytochemistry; (3) surgical resection seems to be the most effective therapy; (4) the exact etiology and adjuvant therapy for relapsing/incompletely resected lesions remain to be established.
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19
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Magnetic resonance imaging of sellar and juxtasellar abnormalities in the paediatric population: an imaging review. Insights Imaging 2015; 6:241-60. [PMID: 25794595 PMCID: PMC4376809 DOI: 10.1007/s13244-015-0401-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 02/11/2015] [Accepted: 02/17/2015] [Indexed: 12/18/2022] Open
Abstract
The sellar and juxtasellar regions in the paediatric population are complex both anatomically and pathologically, with magnetic resonance imaging (MRI) being the "gold standard" imaging modality due to the high contrast of detail. Assessment requires a detailed understanding of the anatomy, embryology, pathophysiology and normal signal characteristics of the pituitary gland and surrounding structures in order to appropriately characterise abnormalities. This article aims to provide an overview of the imaging characteristics of developmental/congenital and acquired disease processes which affect the sellar and juxtasellar region in the paediatric population. Main Messages • The sellar region is anatomically complex and covers a wide pathology spectrum. • MRI is the key imaging modality to assess sellar and juxtasellar pathology. • Numerous developmental anomalies may not be discovered until adulthood. • Knowledge of pathology alerts and guides the clinician towards appropriate management.
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20
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Tian Y, Wang J, Ge JZ, Ma Z, Ge M. Intracranial Rosai-Dorfman disease mimicking multiple meningiomas in a child: a case report and review of the literature. Childs Nerv Syst 2015; 31:317-23. [PMID: 25183389 DOI: 10.1007/s00381-014-2536-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 08/18/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Rosai-Dorfman disease (RDD) is a rare idiopathic, non-neoplastic histioproliferative disease. Central nervous system (CNS) manifestations are extremely rare. In this paper, we describe a 6-year-old boy with intracranial RDD mimicking multiple meningiomas both clinically and radiologically. We reviewed the literature to understand the clinical behaviour, clinicopathological features and treatment options. METHODS A PubMed (US National Library of Medicine) search using the keywords 'Rosai-Dorfman disease' and 'central nervous system' was performed and citations were reviewed. RESULTS Eighty-five cases of RDD involving the CNS have been reported until date, and only 7 cases involved children. Of the 85 cases, 16 cases mimicked multiple meningiomas. Our case is the first to involve multiple lesions in a child under 14 years old. CONCLUSION After reviewing the literature, we concluded that RDD should be considered as a differential diagnosis for lesions mimicking multiple meningiomas, especially in children. Resection of the intracranial lesion is the most effective treatment, and a definitive diagnosis should be based on histopathologic and immunocytochemical examinations.
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Affiliation(s)
- Yongji Tian
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
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21
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Rosai-Dorfman disease: a case report with nodal and cutaneous involvement and review of the literature. Am J Dermatopathol 2014; 36:353-7. [PMID: 23863552 DOI: 10.1097/dad.0b013e31829e5564] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy, is a benign proliferative disorder of histiocytes with an unknown etiology. It is a rare disease characterized by overproduction and accumulation of histiocytes within lymph node sinuses and many other extranodal sites, including skin, oral and nasal cavities, respiratory tract, eyelid, and periorbital area. In this case, a 44-year-old woman with diagnosis of Rosai-Dorfman disease, with xanthelasma-like cutaneous lesions on facial area, extending to her neck and acneiform papules on her back, cervical lymph node involvement, and concomitant presence of diabetes insipidus was presented. Histopathological examination of the lesions demonstrated diffuse lymphocyte, plasmocyte, eosinophil, and sparse neutrophil infiltration, together with histiocytes showing phagocytosed inflammatory cells (emperipolesis). Histiocytes demonstrated immunoreactivity with the antibodies for CD68 and S100, whereas they were negative for CD1a and Langerin. Laboratory tests were normal, except mild immunoglobulin G hypergammaglobulinemia. Systemic methylprednisolone therapy was effective for cutaneous lesions.
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22
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Sciacca S, Barkas K, Heptinstall L, McNamara C, Shetty R. Rosai-Dorfman disease with spinal cord compression: a diagnostic challenge. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 24 Suppl 4:S529-35. [PMID: 25398443 DOI: 10.1007/s00586-014-3671-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 11/03/2014] [Accepted: 11/03/2014] [Indexed: 12/31/2022]
Abstract
PURPOSE Rosai-Dorfman disease (RDD) is an uncommon benign histiocytic proliferative disorder commonly involving the cervical lymph nodes and less frequently extranodal sites, including, rarely, the central nervous system, mainly intracranially. Spinal involvement is unusual. RDD is characterized by pathognomonic histopathological features, which are decisive in the definitive diagnosis. We present the case of a 75-year-old lady who presented with an isolated thoracic vertebral lesion. She underwent 3 CT-guided biopsies, all not confirmative for a definite diagnosis, and 2 open biopsies and debulking of the lesion. METHODS The clinical notes, operation notes, investigations and clinic letters of the patient were reviewed. A literature search was performed using PubMed, with the keywords "Rosai-Dorfman disease", "sinus histiocytosis with massive lymphadenopathy", "histiocytic proliferative disorder". RESULTS Only the histopathology after the last procedure was diagnostic for Rosai-Dorfman disease. The patient was treated with steroids with marked improvement in her clinical condition. CONCLUSIONS This case demonstrates the challenge in making a diagnosis. RDD should be considered as a differential diagnosis in case of spinal lesion and non-diagnostic biopsy, especially in steroid sensitive lesions. The implications of the case are discussed.
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Affiliation(s)
- Sara Sciacca
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK,
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23
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Sandoval-Sus JD, Sandoval-Leon AC, Chapman JR, Velazquez-Vega J, Borja MJ, Rosenberg S, Lossos A, Lossos IS. Rosai-Dorfman disease of the central nervous system: report of 6 cases and review of the literature. Medicine (Baltimore) 2014; 93:165-175. [PMID: 24797172 PMCID: PMC4632912 DOI: 10.1097/md.0000000000000030] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy (SHML), is an uncommon benign idiopathic lymphoproliferative disorder. The histologic hallmark of RDD is the finding of emperipolesis displayed by lesional histiocytes. While RDD most commonly affects lymph nodes, extranodal involvement of multiple organs has been reported, including the central nervous system (CNS). However, CNS involvement in RDD is rare and is not well characterized. As a result, therapeutic approaches to CNS involvement in RDD are not well established. Herein we report 6 cases of RDD with isolated CNS involvement and review the literature on RDD with CNS involvement. One of the presented cases exhibited intramedullary involvement of the spinal cord--a very rare form of RDD with CNS involvement.
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Affiliation(s)
- Jose D Sandoval-Sus
- From the Department of Medicine (JDS-S, ACS-L, ISL), Department of Pathology (JRC, JV-V), and Department of Radiology (MJB), University of Miami, Miami, Florida, Division of Hematology-Oncology (ISL), Department of Medicine, and Department of Molecular and Cellular Pharmacology (ISL), University of Miami, Sylvester Comprehensive Cancer Center, Miami, Florida, and Department of Neurology (SR, AL), Hebrew University-Hadassah Medical Center, Jerusalem, Israel
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24
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Radiology–pathology case report: isolated extranodal Rosai–Dorfman disease of the skull base. Clin Imaging 2013; 37:1146-8. [DOI: 10.1016/j.clinimag.2013.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 07/05/2013] [Indexed: 11/21/2022]
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Abstract
Rosai-Dorfman disease (RDD)-sinus histiocytosis with massive lymphadenopathy-represents a peculiar proliferation of histiocyte-like cells in patients. The condition was described by Rosai and Dorfman in 1969, after examining 4 cases, as an idiopathic histiocytic disorder. In 1972, they studied an additional 30 cases of patients with RDD. A histioproliferative disorder, RDD is characterized by bilateral, painless, cervical lymphadenopathy in 81% of patients. Fever, leukocytosis, elevated sedimentation rate, and polyclonal hypergammaglobulinemia may also be found. In 30% of patients, extranodal involvement is present and may include the skin, eye orbit, upper respiratory tract, or testes. Cases involving the central nervous system are rare and account for < 5% of patients with RDD. We report on a 78-year-old woman presenting with new-onset headache, dizziness, and imbalance, which had been present for a few weeks prior to admission. Magnetic resonance imaging of the brain showed 2 enhancing lesions within the right and left cerebellar hemispheres. Biopsy of the mass demonstrated a lymphohistiocytic infiltrate involving the cerebellum with foci of emperipolesis (phagocytosed lymphocytes). The adjacent cerebellum showed myelinated nerve fibers with reactive gliosis. A thorough work-up and histopathologic exam of the biopsied mass demonstrated lymphohistiocytic infiltrate with foci of emperipolesis (phagocytosed lymphocytes) consistent with RDD. Other differential considerations, such as primary or secondary neoplasms, infections, lymphoproliferative disorders, granulomatoses, Langerhans cell histiocytosis, and lymphocyte-rich meningioma were ruled out by additional histopathologic exam.
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Affiliation(s)
- Mervat Wahba
- Associate Professor of Neurology, Neurology Department, University of Tennessee Health Sciences Center, Memphis, TN.
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26
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18F-FDG PET/CT Findings in a Patient With Isolated Intracranial Rosai-Dorfman Disease. Clin Nucl Med 2013; 38:e50-2. [DOI: 10.1097/rlu.0b013e31825ae73b] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Catalucci A, Lanni G, Ventura L, Ricci A, Galzio RJ, Gallucci M. A rare case of intracranial rosai-dorfman disease mimicking multiple meningiomas. A case report and review of the literature. Neuroradiol J 2012; 25:569-74. [PMID: 24029092 DOI: 10.1177/197140091202500510] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 08/16/2012] [Indexed: 11/17/2022] Open
Abstract
Rosai-Dorfman disease (RDD) was firstly described in 1969 as a benign proliferative disorder of histiocytes with systemic symptoms and lymphadenopathy. This disease is of uncertain pathogenesis and mostly occurs in children and young adults. The typical clinical features of RDD include bilateral painless cervical lymphadenopathy, but extranodal involvement may also be present. The most common extranodal sites include organs such as the respiratory tract, skin, nasal cavity, orbit and bone. Isolated central nervous system (CNS) manifestations are extremely rare. In case of CNS involvement, the commonest imaging findings are dural-based extra-axial enhancing masses. We describe a case of intracranial RDD mimicking multiple meningiomas both clinically and radiologically in a 57-year-old man presenting with a six-year history of progressive right visual and hearing loss and tinnitus. In cases of multiple extra-axial lesions it is worth bearing in mind the possible differential diagnosis for intracranial RDD and eventually propose to the patient further investigations.
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Affiliation(s)
- A Catalucci
- Department of Neuroradiology, S. Salvatore Hospital, University of L'Aquila, Italy -
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28
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MR findings of Rosai–Dorfman disease in sellar and suprasellar region. Eur J Radiol 2012; 81:1231-7. [DOI: 10.1016/j.ejrad.2011.02.059] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 02/19/2011] [Accepted: 02/24/2011] [Indexed: 11/23/2022]
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29
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Chourmouzi D, Potsi S, Moumtzouoglou A, Papadopoulou E, Drevelegas K, Zaraboukas T, Drevelegas A. Dural lesions mimicking meningiomas: A pictorial essay. World J Radiol 2012; 4:75-82. [PMID: 22468187 PMCID: PMC3314931 DOI: 10.4329/wjr.v4.i3.75] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 02/28/2012] [Accepted: 03/07/2012] [Indexed: 02/06/2023] Open
Abstract
The purpose of this essay was to illustrate the radiological and pathological findings in a wide spectrum of dural lesions mimicking meningiomas. Familiarity with and knowledge of these findings will narrow the differential diagnosis and provide guidance for patient management. In this pictorial review, we describe the following entities: Solitary fibrous tumors, hemangiopericytoma, gliosarcoma, leiomyosarcoma, dural metastases, Hodgkin’s disease, plasmocytoma, Rosai-Dorfman disease, neurosarcoidosis, melanocytic neoplasms and plasma cell granuloma.
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30
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A clinicopathological study of diagnostically challenging meningioma mimics. J Neurooncol 2011; 106:339-52. [DOI: 10.1007/s11060-011-0669-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 07/13/2011] [Indexed: 11/26/2022]
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31
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Cavuoto K, Galor A, Dubovy SR, Gregori N, McCarthy M. Subconjunctival masses associated with central nervous system rosai-dorfman disease. Cornea 2011; 30:237-40. [PMID: 20847659 DOI: 10.1097/ico.0b013e3181e4570c] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe a case of subconjunctival masses with multiple intracranial masses diagnosed as Rosai-Dorfman disease by biopsy. METHODS Case report. RESULTS A 25-year-old white man presented with bilateral subconjunctival masses, left optic nerve pallor, and posterior segment changes suggestive of regressed choroidal disease. Systemic evaluation was instituted including blood testing, neuroimaging, brain biopsy, and biopsy of the left subconjunctival mass. Pathologic analysis of the brain and subconjunctival mass biopsies revealed Rosai-Dorfman disease. CONCLUSIONS The authors present a case of extensive extranodal involvement of Rosai-Dorfman of the eye and the central nervous system.
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Affiliation(s)
- Kara Cavuoto
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.
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Wang F, Qiao G, Lou X, Song X, Chen W. Intracranial recurrences of Rosai-Dorfman disease in the sellar region: two illustrative cases. Acta Neurochir (Wien) 2011; 153:859-67. [PMID: 21161294 DOI: 10.1007/s00701-010-0895-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Accepted: 11/22/2010] [Indexed: 10/18/2022]
Abstract
Rosai-Dorfman disease [RDD] is a condition of an unknown etiology, characterized by proliferation of histiocytes. Not uncommonly extranodal lesions occur, but sellar involvement is very rare. Treatment of this lesion is complicated, especially in cases of recurrences at multiple intracranial sites. We report two cases of RDD in the sellar region with intracranial recurrences to illustrate the clinicopathological features and considerations of the optimal management.
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Conley A, Manjila S, Guan H, Guthikonda M, Kupsky WJ, Mittal S. Non-Langerhans cell histiocytosis with isolated CNS involvement: an unusual variant of Erdheim-Chester disease. Neuropathology 2011; 30:634-47. [PMID: 20337948 DOI: 10.1111/j.1440-1789.2010.01104.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Benign histiocytic proliferations are identified by their component cells and classified as either Langerhans cell histiocytosis or non-Langerhans cell histiocytosis. We report a 58-year-old Caucasian woman who presented with diabetes insipidus and was found to harbor a large suprasellar mass. Histopathological analysis was consistent with non-LCH. The differential diagnoses included juvenile xanthogranuloma, adult-onset xanthogranuloma, xanthoma disseminatum, Rosai-Dorfman disease, and Erdheim-Chester disease. Immunohistochemical examination demonstrated a proliferation of large lipid-laden histiocytic cells which were positive for CD68, negative for S100 protein, and showed only faint, background staining for CD1a. We present a case of an autopsy-confirmed non-Langerhans cell histiocytosis limited to the central nervous system and evaluated with both immunohistochemical and ultrastructural studies. Based on the multifocality, anatomic distribution, and immunostaining features, a diagnosis of Erdheim-Chester disease was made. This is only the second reported case of Erdheim-Chester disease with intracranial involvement but absence of extracerebral manifestations. Given the overlapping clinicopathologic, radiographic, and immunohistochemical profiles, differentiating between these rare histiocytic disorders can often present a significant diagnostic challenge. A systematic approach using all available clinical, laboratory, radiographic, histologic, immunohistochemical and ultrastructural data is essential for proper discrimination between the numerous histiocytoses.
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Affiliation(s)
- Alexandria Conley
- Department of Neurosurgery, Wayne State University, and Detroit Medical Center, Detroit, MI, USA
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Beros V, Houra K, Rotim K, Zivkovic DJ, Cupic H, Kosec A. Isolated cerebellar intraparenchymal Rosai–Dorfman disease – Case report and review of literature. Br J Neurosurg 2011; 25:292-6. [DOI: 10.3109/02688697.2010.546899] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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35
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Molina-Garrido M, Guillén-Ponce C. Extranodal rosai-dorfman disease with cutaneous and periodontal involvement: a rare presentation. Case Rep Oncol 2011; 4:96-100. [PMID: 21475597 PMCID: PMC3072186 DOI: 10.1159/000324760] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Sinus histiocytosis with massive lymphadenopathy (SHML) or Rosai-Dorfman disease (RDD) was first described as a distinct clinicopathological entity by Rosai and Dorfman in 1969. SHML is commonly characterized by painless cervical lymphadenopathy, and its clinical course is generally benign and self-limiting. This disorder commonly involves the lymph nodes but may secondarily involve the skin. However, purely cutaneous disease without lymphadenopathy or internal organ involvement rarely occurs. In the absence of the massive lymphadenopathy that is characteristic of RDD, the diagnosis of purely cutaneous RDD may be complicated by the rare, nonspecific clinical appearance of skin lesions and the broad histopathological differential diagnosis of this disorder. A high level of suspicion of this disease on the part of the clinician or pathologist is often required. We present a case of cutaneous RDD associated with involvement of periodontal tissue.
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Affiliation(s)
- M.J. Molina-Garrido
- Department of Medical Oncology Hospital General Virgen de la Luz, Cuenca, Spain
| | - C. Guillén-Ponce
- Department of Medical Oncology Hospital Ramón y Cajal, Madrid, Spain
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Triana-Pérez A, Sánchez-Medina Y, Pérez-Del Rosario P, Millán-Corada A, Gómez-Perals L, Domínguez-Báez J. Enfermedad de Rosai-Dorfman intracraneal. Presentación de un caso y revisión de la literatura. Neurocirugia (Astur) 2011. [DOI: 10.1016/s1130-1473(11)70021-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Adeleye AO, Amir G, Fraifeld S, Shoshan Y, Umansky F, Spektor S. Diagnosis and management of Rosai-Dorfman disease involving the central nervous system. Neurol Res 2010; 32:572-8. [PMID: 20350368 DOI: 10.1179/016164109x12608733393836] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Rosai-Dorfman disease is a benign non-neoplastic proliferative disorder of histiocytes originally described in the cervical lymph nodes. Extranodal sites were later recognized, and by 1990, they were shown to represent over 40% of cases; however, central nervous system involvement is still considered rare. We review the literature, which shows a steady increase in reports of Rosai-Dorfman disease involving the brain and/or spine. METHODS A literature search was performed for the period 1969-2008, using multiple search engines, with keywords Rosai-Dorfman disease, central nervous system Rosai-Dorfman disease and sinus histiocytosis with massive lymphadenopathy. RESULTS By December 2008, 111 cases of Rosai-Dorfman disease involving the central nervous system had been reported in the literature, including our cases. In the central nervous system, Rosai-Dorfman disease is ubiquitous. Although it is characterized by unique, indeed pathognomonic, histopathological cytoarchitecture, it may be mistaken for many other neoplastic and inflammatory histioproliferative diseases. Surgical resection with post-operative corticosteroids remains the treatment of choice. CONCLUSIONS Rosai-Dorfman disease involving the central nervous system appears to be more common than previously thought and may well assume a more prominent place in the differential diagnoses of dural-based lesions. Expert awareness of the characteristic histopathology and immunohistochemistry of the disease is required for accurate diagnosis.
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Affiliation(s)
- Amos O Adeleye
- Division of Neurological Surgery, Department of Surgery, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
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Tseng YL, Lin YC, Lo CY, Liao LJ. Rosai-Dorfman disease of the subglottis diagnosed by ultrasound-guided fine-needle aspiration biopsy: a case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2010; 38:103-106. [PMID: 19953629 DOI: 10.1002/jcu.20651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report a case of subglottic narrowing caused by an extranodal deposit of sinus histiocytosis in a 55-year-old man. To the best of our knowledge, no previous reports have described diagnosis using sonographic-guided fine-needle aspiration cytology for Rosai-Dorfman disease of the subglottis. This patient was diagnosed by sonographic-guided fine-needle aspiration biopsy, which revealed lymphocytes, plasma cells, and many foamy, multinuclear histiocytes with preserved lymphocytes in their cytoplasm (emperipolesis). The patient underwent an incisional biopsy of the tumor and received postoperative steroids and low-dose chemotherapy. The subglottic tumor was markedly regressed 6 months later.
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Affiliation(s)
- Yi-Lun Tseng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
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Abstract
Rosai-Dorfman disease is a common benign lymphomatous disorder that involves the lymph nodes and other solid organs. Neurological involvement is rare, and an isolated intracranial Rosai-Dorfman lesion even rarer. Whether isolated intracranial Rosai-Dorfman lesions should be defined as Rosai-Dorfman disease or intradural histiocytosis remains debatable. Although these intracranial masses may radiologically mimic a meningioma, some have diagnostically specific radiological appearances. Because isolated intracranial Rosai-Dorfman lesions are so rarely described their best treatment is controversial. Most patients described in published reports underwent surgery followed in selected cases by adjuvant radiotherapy. Medical therapies achieve conflicting results. Our two case reports, a patient with isolated dural intracranial Rosai-Dorfman lesions and another with multiple intracranial lesions, both without lymphadenopathy, should be of interest to neuroradiologists and neurosurgeons managing similar cases.
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Affiliation(s)
- Natale Russo
- Department of Neurological Sciences, Neurosurgery, Umberto I Hospital - Sapienza University, Rome, Italy.
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Johnston JM, Limbrick DD, Ray WZ, Brown S, Shimony J, Park TS. Isolated cerebellar Rosai-Dorfman granuloma mimicking Lhermitte-Duclos disease. Case report. J Neurosurg Pediatr 2009; 4:118-20. [PMID: 19645543 DOI: 10.3171/2009.3.peds0917] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Rosai-Dorfman disease (RDD) is an idiopathic histioproliferative disorder that rarely involves the CNS. Rosai-Dorfman disease is exceedingly rare in the pediatric population and has never been observed in the cerebellum of a child. The authors present the case of a 14-year-old male with a cerebellar lesion having radiographic characteristics of Lhermitte-Duclos disease. After a period of observation with a presumptive diagnosis of Lhermitte-Duclos disease, the child underwent suboccipital craniotomy and resection of the lesion due to continuous suboccipital headaches. Histological examination of the tissue demonstrated RDD. The published literature on RDD is reviewed with an emphasis on differential diagnosis.
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Affiliation(s)
- James M Johnston
- Department of Neurosurgery, Washington University School of Medicine, Washington, USA
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Rodrigues AC, Medeiros-Neto G. Inflammatory proptosis in Rosai-Dorfman disease simulating thyroid-associated ophthalmopathy. Thyroid 2009; 19:801-2. [PMID: 19583490 DOI: 10.1089/thy.2009.0087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Cunliffe CH, Fischer I, Monoky D, Law M, Revercomb C, Elrich S, Kopp MJ, Zagzag D. Intracranial lesions mimicking neoplasms. Arch Pathol Lab Med 2009; 133:101-23. [PMID: 19123722 DOI: 10.5858/133.1.101] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2008] [Indexed: 11/06/2022]
Abstract
CONTEXT A broad spectrum of nonneoplastic conditions can mimic a brain tumor, both clinically and radiologically. In this review we consider these, taking into consideration the following etiologic categories: infection, demyelination, vascular diseases, noninfectious inflammatory disorders, and iatrogenic conditions. We give an overview of such diseases, which represent a potential pitfall for pathologists and other clinicians involved in patient care, and present selected cases from each category. OBJECTIVE To illustrate the radiologic and pathologic features of nontumoral intracranial lesions that can clinically and radiologically mimic neoplasia. DATA SOURCES Case-derived material and literature review. CONCLUSIONS A variety of nonneoplastic lesions can present clinically and radiologically as primary or metastatic central nervous system tumors and result in surgical biopsy or resection of the lesion. In such situations, the pathologist has an important role to play in correctly determining the nature of these lesions. Awareness of the entities that can present in this way will assist the pathologist in the correct diagnosis of these lesions.
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Affiliation(s)
- Clare H Cunliffe
- Department of Pathology, Division of Neuropathology, New York University Medical Center, New York, NY, USA.
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Hinduja A, Giselle Aguilar L, Steineke T, Nochlin D, Landolfi JC. Rosai-Dorfman disease manifesting as intracranial and intraorbital lesion. J Neurooncol 2008; 92:117-20. [DOI: 10.1007/s11060-008-9733-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 11/03/2008] [Indexed: 11/28/2022]
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Wan S, Teng X, Zhan R, Yu J, Gu J, Zhang K. Isolated intracranial Rosai-Dorfman disease mimicking suprasellar meningioma: case report with review of the literature. J Int Med Res 2008; 36:1134-9. [PMID: 18831912 DOI: 10.1177/147323000803600535] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Rosai-Dorfman disease (RDD) is an idiopathic histiocytic proliferation affecting the lymph nodes. Isolated intracranial RDD is rare and usually appears as a well-defined, dural-based lesion without lymphadenopathy. The clinical and radiological features of intracranial RDD are similar to meningioma. Histopathology and immunohistochemistry are essential for a definitive diagnosis. This is a report of a 43-year old male with isolated intracranial RDD, which manifested as a suprasellar meningioma. The clinical, radiological and pathological aspects of the disease are discussed within the context of a review of previously reported cases.
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Affiliation(s)
- S Wan
- Department of Neurosurgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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SHALABY MAF, AL HUMAYED SM, DEWEDAR AM, EL-SAEED TA. Asymmetric polyarthritis as an initial presentation of Rosai-Dorfman disease. Int J Rheum Dis 2008. [DOI: 10.1111/j.1756-185x.2008.00369.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kraeft SK, Honig M, Krishnamurthy S. Emperipolesis in the cerebrospinal fluid from a patient with Rosai-Dorfman disease. Diagn Cytopathol 2007; 36:67-8. [DOI: 10.1002/dc.20742] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Tavangar SM, Mahta A, Haghpanah V, Larijani B. Extranodal Rosai-Dorfman disease involving the meninges in a 79-year-old man. Ann Saudi Med 2006; 26:474-6. [PMID: 17146206 PMCID: PMC6074338 DOI: 10.5144/0256-4947.2006.474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2006] [Indexed: 11/22/2022] Open
Affiliation(s)
- Seyed Mohammad Tavangar
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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McPherson CM, Brown J, Kim AW, DeMonte F. Regression of intracranial rosai-dorfman disease following corticosteroid therapy. Case report. J Neurosurg 2006; 104:840-4. [PMID: 16703894 DOI: 10.3171/jns.2006.104.5.840] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Rosai-Dorfman disease (RDD) is an idiopathic histioproliferative disorder usually presenting with massive, painless lymphadenopathy. Extranodal involvement has been reported including at least 50 cases affecting the central nervous system (CNS). The treatment of CNS RDD as reported in the literature has primarily involved a surgical technique. The authors report on the case of a 53-year-old man presenting with multiple skull base lesions mimicking meningiomas. The patient suffered visual deterioration and underwent a right orbitopterional craniotomy as well as optic nerve decompression. Histopathological analysis revealed histiocytic cells and emperipolesis consistent with RDD. Following surgery, corticosteroid agents were administered, leading to marked resolution of both the remaining surgically untreated lesions and the balance of the patient's symptoms. This report represents the first case of the resolution of intracranial RDD following corticosteroid therapy. Corticosteroid agents should be considered an effective option in the treatment of CNS RDD.
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Affiliation(s)
- Christopher M McPherson
- Department of Neurosurgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009, USA
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Leiva BJL, Bofill RM, Sevin BU, Geiger XJ. Extranodal Rosai-Dorfman disease as a pelvic mass. Int J Gynecol Cancer 2006; 16 Suppl 1:312-5. [PMID: 16515611 DOI: 10.1111/j.1525-1438.2006.00337.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Rosai-Dorfman disease (RDD) is a rare histiocytic disorder of unknown cause. RDD most commonly involves the cervical lymph nodes, but extranodal involvement has been described. We report the case of a patient with extranodal RDD that presented as a retroperitoneal mass obstructing the left ureter. The patient underwent surgical resection of the mass, followed by a 5-month course of vinblastine. There was no evidence of progressive disease 22 months after surgery.
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Affiliation(s)
- B J L Leiva
- Department of Obstetrics, Mayo Clinic, Jacksonville, Florida 32224, USA
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Z'Graggen WJ, Sturzenegger M, Mariani L, Keserue B, Kappeler A, Vajtai I. Isolated Rosai-Dorfman disease of intracranial meninges. Pathol Res Pract 2005; 202:165-70. [PMID: 16377100 DOI: 10.1016/j.prp.2005.11.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2005] [Accepted: 11/08/2005] [Indexed: 11/18/2022]
Abstract
Rosai-Dorfman disease (RDD) is a non-neoplastic proliferative histiocytic disorder that primarily affects lymph nodes (sinus histiocytosis with massive lymphadenopathy). Primary RDD of the central nervous system is most uncommon. We report on a 35-year-old man with isolated RDD of the meninges overlying the left cerebral hemisphere. Presenting signs and symptoms included severe progressive ipsilateral headaches of 4 months duration, as well as laboratory evidence of mild non-specific systemic inflammatory reaction. On magnetic resonance imaging, the lesion was seen as a contrast-enhancing, plaque-like thickening of the dura mater over the left convexity,without impinging on adjacent bone or cerebral parenchyma. Meningeal biopsy revealed a mixed mononuclear infiltrate dominated by CD68(+), S100(+), CD1a(-) non-Langerhans type histiocytes on a background of fibrosis. Bacteria, in particular mycobacteria, and fungi were excluded with special stains. Extensive clinical workup, encompassing computed tomography of thoracal and abdominal organs, bone marrow biopsy, and bronchoalveolar lavage failed to reveal any extracranial involvement. Laboratory tests for autoimmunity, including C- and P-antineutrophil cytoplasmic antibodies, antinuclear antibody, and serum rheumatoid factor, were negative. Methylprednisolone therapy induced complete remission of symptoms, with the neuroradiologic status remaining unchanged on follow-up after 2 months. We discuss the complex clinicopathologic differential diagnosis and therapeutic issues of this rare condition. While the correct diagnosis of central nervous system RDD is unlikely to be established without invasive procedures (biopsy), a conservative therapeutic approach may be considered a legitimate option.
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Affiliation(s)
- Werner J Z'Graggen
- Department of Neurology and Department of Neurosurgery, University Hospital Berne, Switzerland
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