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Sharma P, Ramteke P, Satapathy A, Ray MD. Xanthogranulomatous Orchitis Presenting as a Scrotal Mass in an Elderly Male: Malignancy or Mimicker? CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2019; 12:1179547619890295. [PMID: 35185347 PMCID: PMC8848033 DOI: 10.1177/1179547619890295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/23/2019] [Indexed: 11/30/2022]
Abstract
Xanthogranulomatous inflammation is a rare, destructive pattern of inflammation, affecting different organs, that often produces a mass-like lesion, simulating malignancy. Although benign, it can coexist with malignancy. We, herein, report the case of a 60-year-old male patient, who presented with a testicular mass that was partly necrotic and showed heterogeneous enhancement on contrast study. Testicular tumor markers were normal. In view of clinicoradiological suspicion of a malignant cause, high inguinal orchidectomy was performed. However, histopathology showed features of a xanthogranulomatous orchitis with no evidence of any malignancy. Pathologists must be aware of this entity as definitive diagnosis requires histopathologic examination and adequate sampling must be done to rule out a coexistent malignancy.
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Affiliation(s)
- Pooja Sharma
- Department of Pathology, AIIMS, New Delhi, India
| | | | | | - MD Ray
- Department of Surgical Oncology, AIIMS, New Delhi, India
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Lami V, Ruggera L, Nguyen AAL, Fanelli GN, Vianello F, Zattoni F. Rosai-Dorfman Disease: Case Report of an Unusual Testicular Involvement and Review of Literature. Clin Genitourin Cancer 2018; 16:e529-e531. [PMID: 29666019 DOI: 10.1016/j.clgc.2018.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 03/21/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Valeria Lami
- Department of Surgery, Oncology, and Gastroenterology-Urology Clinic, University of Padua, Padua, Italy.
| | - Lorenzo Ruggera
- Department of Surgery, Oncology, and Gastroenterology-Urology Clinic, University of Padua, Padua, Italy
| | - Alex Anh Ly Nguyen
- Department of Surgery, Oncology, and Gastroenterology-Urology Clinic, University of Padua, Padua, Italy
| | - Giuseppe Nicolò Fanelli
- Department of Medicine, Surgical Pathology, and Cytopathology Unit, University of Padua, Padua, Italy
| | - Fabio Vianello
- Department of Surgery, Oncology, and Gastroenterology-Urology Clinic, University of Padua, Padua, Italy
| | - Filiberto Zattoni
- Department of Surgery, Oncology, and Gastroenterology-Urology Clinic, University of Padua, Padua, Italy
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Extranodal Rosai-Dorfman disease in the scrotum of a 13-month male: a unique anatomic presentation. Am J Dermatopathol 2015; 37:88-90. [PMID: 24999545 DOI: 10.1097/dad.0000000000000113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rodríguez Torres C, Riazuelo Fantova G, Escartín Martínez I, Castillo Escudero JJ, del Agua Arias C. Rosai-Dorfman disease with atypical intrascrotal involvement. Int J Urol 2015; 22:794-6. [PMID: 25988924 DOI: 10.1111/iju.12805] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 04/01/2015] [Indexed: 11/30/2022]
Abstract
We describe two new cases of Rosai-Dorfman disease with intrascrotal involvement. Also known as sinus histiocytosis with massive lymphadenopathy, this is a rare entity, usually presenting with massive bilateral cervical lymphadenopathy. It is associated with extranodal involvement in up to 40% of cases, commonly in the face and neck area. Isolated intrascrotal involvement with no lymphadenopathies is extremely rare, and its definitive diagnosis is histopathological. Although they are the most frequent type, not all intrascrotal lesions are neoplastic; therefore, it is important to know other possible etiologies and their radiogical features that might help in the diagnosis. We also review other cases of intrascrotal involvement reported in the literature, as well as a review clinical features, treatment and prognosis of this entity, and a differential diagnosis of solid intrascrotal lesions.
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Affiliation(s)
| | | | | | | | - Celia del Agua Arias
- Department of Anatomic Pathology, Miguel Servet University Hospital, Zaragoza, Spain
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Novice surgeons: do they benefit from 3D laparoscopy? Lasers Med Sci 2015; 30:1325-33. [DOI: 10.1007/s10103-015-1739-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
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Ma H, Zheng Y, Zhu G, Wu J, Lu C, Lai W. Rosai-dorfman disease with massive cutaneous nodule on the shoulder and back. Ann Dermatol 2015; 27:71-5. [PMID: 25673935 PMCID: PMC4323606 DOI: 10.5021/ad.2015.27.1.71] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 06/01/2013] [Accepted: 08/09/2013] [Indexed: 11/08/2022] Open
Abstract
Rosai-Dorfman disease is a rare, idiopathic, benign, and self-limiting histiocytic proliferative disorder. A 26-year-old man presented with a single massive cutaneous nodule (reaching 30 cm in diameter) on the left shoulder and back for 15 months. The routine hematological and biochemical tests were normal. Magnetic resonance scanning showed the lesion involved the skin, subcutaneous tissue, and subjacent muscle group, accompanied by obvious lymph node enlargement in the left part of the neck, supraclavicular fossa, and axillary fossa. The histopathology of the left cervical lymph node revealed diffuse effacement of the normal nodal architecture, with patchy chronic inflammatory cell infiltrates comprising lymphocytes and sheets of histiocytes. Some histiocytes contained lymphocytes within their pale cytoplasm. Many multinucleated giant cells were found; however, caseating granulomas were not seen. The skin and muscle biopsy specimen obtained from the back revealed infiltrating lymphocytes and histiocytes diffusely distributed in the dermis, subcutaneous tissue, and crevices of the muscle fibers. The phenomenon of emperipolesis and the presence of multinucleated giant cells were also seen. Immunohistochemical staining revealed that the histiocytes were positive for S-100 protein and CD68 but negative for CD1a. Immunophenotyping of the infiltrating lymphocytes indicated positive reactions to CD3, CD45RO, CD5, CD7, CD4, CD8 (partly), CD79a, CD20 (partly), and Ki-67 (<1%). The final diagnosis was Rosai-Dorfman disease. Owing to the extensive and deep involvement of the subcutaneous tissue and muscles, the patient did not undergo surgery to excise the massive skin nodule. The lesion showed no obvious change at the 12-month follow-up.
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Affiliation(s)
- Han Ma
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yue Zheng
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Guoxing Zhu
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jie Wu
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Chun Lu
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wei Lai
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Wang CC, Al-Hussain TO, Serrano-Olmo J, Epstein JI. Rosai-Dorfman disease of the genito-urinary tract: analysis of six cases from the testis and kidney. Histopathology 2014; 65:908-16. [DOI: 10.1111/his.12494] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 07/05/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Chung-Chieh Wang
- Department of Pathology; National Taiwan University Hospital and College of Medicine; National Taiwan University; Taipei Taiwan
| | - Turki O Al-Hussain
- Department of Pathology; King Faisal Specialist Hospital; Riyadh Saudi Arabia
| | - Juan Serrano-Olmo
- Department of Pathology; Hospital Hima-San Pablo Bayamon; Bayamon Puerto Rico
| | - Jonathan I Epstein
- Departments of Pathology, Urology and Oncology; The Johns Hopkins Hospital; Baltimore MD USA
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Ma H, Huang H, Li M, Lai W, Lu C. Case for diagnosis. Cutaneous Rosai-Dorfman disease. An Bras Dermatol 2014; 89:171-2. [PMID: 24626670 PMCID: PMC3938376 DOI: 10.1590/abd1806-4841.20142485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 02/14/2013] [Indexed: 11/22/2022] Open
Abstract
Cutaneous Rosai-Dorfman disease is a rare, lymphoproliferative disease. It is benign and self-limited, only involves skin and subcutaneous tissue and typically occurs as histiocyte-rich inflammatory infiltrates, manifesting as erythematous to brown papules, plaques, or nodules, without predilection for site. The authors describe a case of cutaneous Rosai-Dorfman disease in a 72-year-old man who presented erythematous and scaled plaque on the right neck for three months without systemic symptoms. Owing to local involvement, the patient received a surgery to exsect the lesion completely and remained asymptomatic with no signs of recurrence at the 9-month follow up.
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Affiliation(s)
- Han Ma
- Sun Yat-sen University, Third Affiliated Hospital, GuangzhouGuangdong, China, M.D, Dr. at the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou - Guangdong, China
| | - Huaiqiu Huang
- Sun Yat-sen University, Third Affiliated Hospital, GuangzhouGuangdong, China, Ph.D., Prof. at the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou - Guangdong, China
| | - Meirong Li
- Sun Yat-sen University, Third Affiliated Hospital, GuangzhouGuangdong, China, Bachelor degree, Dr. at the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou - Guangdong, China
| | - Wei Lai
- Sun Yat-sen University, Third Affiliated Hospital, GuangzhouGuangdong, China, M.D. Prof., Third Affiliated Hospital of Sun Yat-sen University, Guangzhou - Guangdong, China
| | - Chun Lu
- Sun Yat-sen University, Third Affiliated Hospital, GuangzhouGuangdong, China, M.D. Prof., Third Affiliated Hospital of Sun Yat-sen University, Guangzhou - Guangdong, China
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Mallick S, Ghosh R, Iyer VK, Jain D, Mathur SR. Cytomorphological and morphometric analysis of 22 cases of Rosai-Dorfman disease: a large series from a tertiary care centre. Acta Cytol 2013; 57:625-32. [PMID: 24192148 DOI: 10.1159/000354947] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 07/23/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Rosai-Dorfman disease (RDD) is a rare benign idiopathic histiocytic proliferation. Most commonly reported cases are lymph nodal. Only 30-40% of cases occur in extranodal sites. Although the morphological features of RDD are well documented, there is limited information about the morphometric variations in the histiocytes of this entity. METHOD Twenty-two cases of RDD diagnosed on fine-needle aspiration cytology (FNAC) were retrieved from the archives. Both Papanicolaou- and May-Grünwald-Giemsa-stained slides were available for evaluation in all cases. Nuclear area, diameter and histiocyte size were measured taking reactive histiocytes as controls. RESULTS Among the 22 patients (male/female ratio 3:2; age range 5-55 years, mean 26 years), 3 cases were extranodal and 19 cases were nodal. The nodal sites included cervical, axillary, inguinal and submandibular lymph nodes. The extranodal sites were the retroperitoneum, mediastinum and skin. The most common clinical presentation was enlarged lymph nodes. Cytological features included numerous large benign histiocytes with emperipolesis. All the morphometric parameters were significantly (p < 0.01) higher in RDD histiocytes than in histiocytes in the reactive lymph node. CONCLUSIONS In view of the rarity of the disease and the variable clinical presentation in RDD, accurate diagnosis is necessary. This is the first study to document the morphometric parameters of RDD histiocytes and their comparison with histiocytes in the reactive lymph node.
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Affiliation(s)
- Saumyaranjan Mallick
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Val-Bernal JF, Argueta L, Fernández-Flórez A, Correas MA, Val D, Garijo MF, López-Rasines G. Bilateral xanthogranulomatous orchitis in a tetraplegic patient. Pathol Res Pract 2012; 208:62-4. [PMID: 22177594 DOI: 10.1016/j.prp.2011.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2011] [Accepted: 11/07/2011] [Indexed: 10/14/2022]
Abstract
Xanthogranulomatous orchitis (XGO) is a rare chronic inflammatory process characterized by destruction of tissue that is replaced by an outstanding cellular infiltrate of lipid-laden macrophages. To date, 20 cases of this process have been reported previously. We present herein the case of a 55-year-old man who had sustained complete tetraplegia at C-6 level and neuropathic bladder for 21 years. After repeated episodes of urinary tract infection, the patient developed a bilateral XGO and a right xanthogranulomatous epididymitis (XGE) that were treated with bilateral orchiepididymectomy. To our knowledge, a bilateral XGO has not yet been reported. Repeated episodes of high-pressure urinary reflux along the vas deferens during dyssynergic voiding possibly led to retrograde extension from the urinary tract by common urinary pathogens and development of bilateral XGO and right XGE. Since tissue destruction is a feature of this process, curative treatment required antibiotic therapy followed by bilateral excision of testes and epididymes.
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Affiliation(s)
- J Fernando Val-Bernal
- Pathology Department, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IFIMAV, Santander, Spain.
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Kusutani N, Tamiya H, Tsuruta D, Mizuno N, Sowa J, Kaida M, Ishii M, Yamamoto O, Kobayashi H. Apoptosis of neutrophils resulting after emperipolesis in cutaneous Rosai-Dorfman disease: a new ultrastructural finding. J Cutan Pathol 2011; 38:529-31. [DOI: 10.1111/j.1600-0560.2011.01678.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Val-Bernal JF, González-Márquez P, Ramos-Barseló E, Portillo JA. Concurrent xanthogranulomatous orchiepididymitis and seminoma in the same testis. Pathol Int 2010; 60:55-8. [PMID: 20055953 DOI: 10.1111/j.1440-1827.2009.02475.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Xanthogranulomatous orchiepididymitis (XGO) is a rare inflammatory and destructive disease of the testis that may simulate testicular malignancy. To the authors' knowledge only 19 cases of XGO have been previously reported. Herein is reported the case of a 52-year-old man with XGO who presented with a left testicular mass and pyogenic discharge from the scrotum. Ultrasound examination indicated heterogeneous testicular areas suggestive of neoplasia. Testicular tumor markers were normal. Orchidectomy was performed and histopathology showed XGO and a concurrent, occult typical seminoma. As far as the authors know the coincidence of these two lesions has not been documented previously. XGO may mimic testicular malignancy and may coexist with it. Pathologists should be aware of this concurrence of lesions to avoid potential misdiagnosis. Wide sampling of the orchidectomy specimens with XGO is mandatory to exclude an occult seminoma.
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Affiliation(s)
- J Fernando Val-Bernal
- Department of Anatomical Pathology, Medical Faculty, University of Cantabria, Santander, Spain.
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Suson K, Mathews R, Goldstein JD, Dehner LP. Juvenile xanthogranuloma presenting as a testicular mass in infancy: a clinical and pathologic study of three cases. Pediatr Dev Pathol 2010; 13:39-45. [PMID: 19968486 DOI: 10.2350/09-06-0665-oa.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Juvenile xanthogranulomas (JXG) is a histiocytic disorder whose most common clinical presentation is a solitary cutaneous nodule in a child under 5 years of age, but it has come to be recognized that solitary extracutaneous lesions may present in a number of sites, including the soft tissues and various organs. Involvement of the genitourinary tract has been documented in children with multifocal or systemic JXG. The current report describes our experience with 3 cases of JXG presenting as a solitary mass in the testicle of infants between 2.5 and 13 months without manifestations of JXG elsewhere. The masses were intratesticular and had an infiltrative pattern of interstitial growth by mononuclear, histiocyte-like cells with replacement of seminiferous tubules and involvement of the epididymis whose pattern resembled leukemic and lymphomatous involvement of the testis. Because extracutaneous lesions of JXG may have few or no Touton giant cells, immunohistochemistry is an important adjunct to the histopathologic diagnosis. One of the previous 2 cases in the literature of JXG of the testis recurred after partial resection without an orchiectomy. Neither of the 2 youngest patients has experienced a local recurrence of JXG elsewhere in excess of 1 year since the original orchiectomy. The oldest patient, who was treated with partial orchiectomy, remains free of recurrence after 3 months of follow-up. Though uncommon, JXG joins several other distinctive neoplasms presenting in the infantile testis.
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Affiliation(s)
- Kristina Suson
- University of Maryland Medical Center, 29 S. Greene Street, Suite 500, Baltimore, MD 21201, USA
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Algaba F, Mikuz G, Boccon-Gibod L, Trias I, Arce Y, Montironi R, Egevad L, Scarpelli M, Lopez-Beltran A. Pseudoneoplastic lesions of the testis and paratesticular structures. Virchows Arch 2007; 451:987-97. [PMID: 17805564 PMCID: PMC2082069 DOI: 10.1007/s00428-007-0502-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Revised: 07/31/2007] [Accepted: 08/15/2007] [Indexed: 01/26/2023]
Abstract
Pseudotumors or tumor-like proliferations (non-neoplastic masses) and benign mimickers (non-neoplastic cellular proliferations) are rare in the testis and paratesticular structures. Clinically, these lesions (cysts, ectopic tissues, and vascular, inflammatory, or hyperplastic lesions) are of great interest for the reason that, because of the topography, they may be relevant as differential diagnoses. The purpose of this paper is to present an overview of the pseudoneoplasic entities arising in the testis and paratesticular structures; emphasis is placed on how the practicing pathologist may distinguish benign mimickers and pseudotumors from true neoplasia. These lesions can be classified as macroscopic or microscopic mimickers of neoplasia.
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Affiliation(s)
- F Algaba
- Pathology section, Fundació Puigvert, Barcelona, Spain.
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