1
|
Bruce-Brand C, Schneider JW, Schubert P. Rosai-Dorfman disease: an overview. J Clin Pathol 2020; 73:697-705. [PMID: 32591351 DOI: 10.1136/jclinpath-2020-206733] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 12/24/2022]
Abstract
CONTEXT Rosai-Dorfman disease is an uncommon histiocytic disorder most frequently presenting as bilateral cervical lymphadenopathy in children and young adults. Extranodal disease occurs in a significant proportion of patients. It has been recently classified as part of the 'R group' of histiocytoses by the Histiocyte Society in 2016. Cutaneous Rosai-Dorfman disease is regarded as a separate disease entity that falls into the 'C group' of histiocytoses according to this classification system. The pathogenesis was previously poorly understood; however, recent evidence demonstrating clonality in a subset of cases raises the possibility of a neoplastic process. A possible association with IgG4-related disease remains controversial. OBJECTIVES To provide a comprehensive review of Rosai-Dorfman disease, including nodal, extranodal and cutaneous forms, with a particular emphasis on new insights into the possible clonal nature of the disease; to discuss the recently revised classification of the histiocytoses by the Histiocyte Society; and to summarise the findings from the literature regarding the controversial association with IgG4-related disease. DATA SOURCES This review is based on published peer-reviewed English literature. CONCLUSIONS Classic Rosai-Dorfman disease, which may be sporadic or familial, is considered a separate entity from cutaneous disease, which is reflected in the revised classification of histiocytoses. An increase in IgG4-positive plasma cells may be seen in Rosai-Dorfman disease. This finding in isolation is of limited significance and should be interpreted with caution. Studies investigating the molecular profile of the disease show that in at least a subset of cases the disease is a clonal process. The classification of Rosai-Dorfman disease is therefore likely to change as our understanding of the aetiopathogenesis evolves.
Collapse
Affiliation(s)
- Cassandra Bruce-Brand
- Stellenbosch University, Faculty of Medicine and Health Sciences, Division of Anatomical Pathology, Cape Town, South Africa .,National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| | - Johann W Schneider
- Stellenbosch University, Faculty of Medicine and Health Sciences, Division of Anatomical Pathology, Cape Town, South Africa.,National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| | - Pawel Schubert
- Stellenbosch University, Faculty of Medicine and Health Sciences, Division of Anatomical Pathology, Cape Town, South Africa.,National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| |
Collapse
|
2
|
Garces S, Yin CC, Patel KP, Khoury JD, Manning JT, Li S, Xu J, Pina-Oviedo S, Johnson MR, González S, Molgó M, Ruiz-Cordero R, Medeiros LJ. Focal Rosai-Dorfman disease coexisting with lymphoma in the same anatomic site: a localized histiocytic proliferation associated with MAPK/ERK pathway activation. Mod Pathol 2019; 32:16-26. [PMID: 30323237 DOI: 10.1038/s41379-018-0152-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/03/2018] [Accepted: 09/04/2018] [Indexed: 01/12/2023]
Abstract
Rosai-Dorfman disease is a rare histiocytic disorder shown to have gene mutations that activate the MAPK/ERK pathway in at least one-third of cases. Most patients with Rosai-Dorfman disease present with bulky lymphadenopathy or extranodal disease, but rarely Rosai-Dorfman disease is detected concomitantly with lymphoma in the same biopsy specimen. The underlying molecular mechanisms of focal Rosai-Dorfman disease occurring in the setting of lymphoma have not been investigated. We report 12 cases of Rosai-Dorfman disease and lymphoma involving the same anatomic site. There were five men and seven women (age, 23 to 77 years) who underwent lymph node (n = 11) or skin (n = 1) biopsy; the lymphomas included nodular lymphocyte predominant Hodgkin lymphoma (n = 6), classical Hodgkin lymphoma (n = 4), small lymphocytic lymphoma (n = 1) and extranodal marginal zone lymphoma (n = 1). The foci of Rosai-Dorfman disease in all cases had S100 protein-positive histiocytes undergoing emperipolesis. No patients had Rosai-Dorfman disease at other anatomic sites at initial diagnosis and at last follow-up (median, 40 months). We performed immunohistochemical analysis to assess activity of the MAPK/ERK pathway in the Rosai-Dorfman disease foci. We also micro-dissected disease foci and analyzed 146 genes using next-generation sequencing in four cases with adequate DNA; the panel included genes previously reported to be mutated in Rosai-Dorfman disease. All cases were negative for gene mutations. Nevertheless, all cases were positive for cyclin D1 and most cases showed p-ERK expression indicating that the MAPK/ERK pathway is active in the histiocytes of focal Rosai-Dorfman disease. We conclude that focal Rosai-Dorfman disease coexisting with lymphoma is a clinically benign and localized histiocytic proliferation. These data also indicate that the MAPK/ERK pathway is active in focal Rosai-Dorfman disease although we did not identify activating mutations. These findings suggest that the pathogenesis of focal Rosai-Dorfman disease is different from that of usual cases of Rosai-Dorfman disease.
Collapse
Affiliation(s)
- Sofia Garces
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Keyur P Patel
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John T Manning
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sergio Pina-Oviedo
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Malisha R Johnson
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sergio González
- Department of Pathology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Montserrat Molgó
- Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Roberto Ruiz-Cordero
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| |
Collapse
|
3
|
Edelman A, Patterson B, Donovan K, Malone J, Callen J. Rosai-Dorfman disease with a concurrent mantle cell lymphoma. JAAD Case Rep 2019; 5:40-43. [PMID: 30581934 PMCID: PMC6287090 DOI: 10.1016/j.jdcr.2018.09.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Alexandra Edelman
- Division of Dermatology, University of Louisville, Louisville, Kentucky
| | | | | | | | | |
Collapse
|
4
|
Bezerra Lima L, Alves Sobreira-Neto M, Braga-Neto P, Ribeiro Nóbrega P. Isolated central nervous system Rosai-Dorfman disease and breast cancer: an unusual presentation. Int J Neurosci 2018; 129:393-396. [PMID: 30296195 DOI: 10.1080/00207454.2018.1533823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The association between Rosai-Dorfman Disease (RDD) and cancer was reported for the first time in 1984. However, there are still a small number of reports of this association. We describe a 60-year-old woman who presented with a focal onset motor seizure followed by tonic-clonic generalization and persistent headache. Magnetic Resonance Imaging disclosed an irregular hyperintense lesion in T2 and vasogenic edema in the left parietal region. Immunohistochemical analysis of a biopsy fragment was positive for protein S-100 and CD68 and negative for CD1a, compatible with the diagnosis of RDD. She previously had breast cancer six years earlier and had used tamoxifen for two years and anostrozol for three years after diagnosis of cancer. RDD has been already associated with different cancers, such as Hodgkin's lymphoma, non-Hodgkin's lymphoma, follicular lymphoma, melanoma, adenocarcinoma and small cell lung cancer. As far as we know, this is the first report of an association between breast cancer and RDD.
Collapse
Affiliation(s)
- Lailson Bezerra Lima
- a Neurology Service Hospital Universitário Walter Cantídio Universidade Federal do Ceará , Fortaleza, Ceará , Brazil
| | - Manoel Alves Sobreira-Neto
- a Neurology Service Hospital Universitário Walter Cantídio Universidade Federal do Ceará , Fortaleza, Ceará , Brazil.,b Division of Neurology, Department of Clinical Medicine , Universidade Federal do Ceará , Fortaleza, Ceará , Brazil
| | - Pedro Braga-Neto
- a Neurology Service Hospital Universitário Walter Cantídio Universidade Federal do Ceará , Fortaleza, Ceará , Brazil.,b Division of Neurology, Department of Clinical Medicine , Universidade Federal do Ceará , Fortaleza, Ceará , Brazil.,c Center of Health Sciences, Universidade Estadual do Ceará , Fortaleza, Ceará , Brazil
| | - Paulo Ribeiro Nóbrega
- a Neurology Service Hospital Universitário Walter Cantídio Universidade Federal do Ceará , Fortaleza, Ceará , Brazil.,b Division of Neurology, Department of Clinical Medicine , Universidade Federal do Ceará , Fortaleza, Ceará , Brazil
| |
Collapse
|
5
|
Akria L, Sonkin V, Braester A, Cohen HI, Suriu C, Polliack A. Rare coexistence of Rosai-Dorfman disease and nodal marginal zone lymphoma complicated by severe life-threatening autoimmune hemolytic anemia. Leuk Lymphoma 2013; 54:1553-6. [PMID: 23270580 DOI: 10.3109/10428194.2012.740564] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
MESH Headings
- Anemia, Hemolytic, Autoimmune/complications
- Anemia, Hemolytic, Autoimmune/diagnosis
- Antigens, CD20/metabolism
- Histiocytosis, Sinus/complications
- Histiocytosis, Sinus/diagnosis
- Humans
- Lymph Nodes/metabolism
- Lymph Nodes/pathology
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Male
- Middle Aged
Collapse
|
6
|
Llamas-Velasco M, Cannata J, Dominguez I, García-Noblejas A, Aragües M, Fraga J, Arranz R. Coexistence of Langerhans cell histiocytosis, Rosai-Dorfman disease and splenic lymphoma with fatal outcome after rapid development of histiocytic sarcoma of the liver. J Cutan Pathol 2012; 39:1125-30. [DOI: 10.1111/cup.12013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Revised: 05/20/2012] [Accepted: 06/29/2012] [Indexed: 12/25/2022]
Affiliation(s)
- Mar Llamas-Velasco
- Department of Dermatology; Hospital Universitario de La Princesa; Madrid; Spain
| | - Jimena Cannata
- Department of Haematology; Hospital Universitario de La Princesa; Madrid; Spain
| | | | - Ana García-Noblejas
- Department of Haematology; Hospital Universitario de La Princesa; Madrid; Spain
| | - Maximiliano Aragües
- Department of Dermatology; Hospital Universitario de La Princesa; Madrid; Spain
| | - Javier Fraga
- Department of Pathology; Hospital Universitario de La Princesa; Madrid; Spain
| | - Reyes Arranz
- Department of Haematology; Hospital Universitario de La Princesa; Madrid; Spain
| |
Collapse
|
7
|
Primary Splenic Diffuse Large B-Cell Lymphoma in a Patient With Thymus Rosai-Dorfman Disease. Am J Med Sci 2012; 344:155-9. [DOI: 10.1097/maj.0b013e31824e940d] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
8
|
Konca C, Özkurt ZN, Deger M, Akı Z, Yağcı M. Extranodal multifocal Rosai-Dorfman disease: response to 2-chlorodeoxyadenosine treatment. Int J Hematol 2008; 89:58-62. [PMID: 19020950 DOI: 10.1007/s12185-008-0192-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Revised: 09/22/2008] [Accepted: 10/07/2008] [Indexed: 10/21/2022]
Abstract
Rosai-Dorfman disease (RDD) or "sinus histiocytosis with massive lymphadenopathy" is a rare lymphoproliferative disorder of unknown etiology. The disease usually presents with painless lymphadenopathy with occasional extranodal involvement in various organs. We report a case of a 36-year-old man with a history of non-Hodgkin lymphoma (NHL), who recently presented with inguinal lymphadenopathy. Following the diagnosis of RDD on lymph node biopsy, he developed symptoms of spinal cord compression due to a mass lesion discovered at T6-7 vertebral level. 18F-Fluorodeoxyglucose (18FDG) positron emission tomography (PET-CT) revealed extensive disease with lung, renal and bone involvement. The patient received a short course of steroid therapy for cord compression findings and 2-chlorodeoxyadenosine (2-CdA) treatment was initiated for long-term disease control. He had a dramatic sustained response to treatment with six courses of 2-CdA. These results suggest that 2-CdA can be an effective treatment of choice and positron emission tomography with 18FDG can be used for determining the extent of disease and for follow-up in RDD.
Collapse
Affiliation(s)
- Ceyla Konca
- Internal Medicine Department, Faculty of Medicine, Gazi University, 40, Sok. 7/7 Burcak Apt., Bahcelievler, 06500, Ankara, Turkey.
| | - Zübeyde N Özkurt
- Division of Hematology, Internal Medicine Department, Faculty of Medicine, Gazi University, 40, Sok. 7/7 Burcak Apt., Bahcelievler, 06500, Ankara, Turkey
| | - Müge Deger
- Internal Medicine Department, Faculty of Medicine, Gazi University, 40, Sok. 7/7 Burcak Apt., Bahcelievler, 06500, Ankara, Turkey
| | - Zeynep Akı
- Division of Hematology, Internal Medicine Department, Faculty of Medicine, Gazi University, 40, Sok. 7/7 Burcak Apt., Bahcelievler, 06500, Ankara, Turkey
| | - Münci Yağcı
- Division of Hematology, Internal Medicine Department, Faculty of Medicine, Gazi University, 40, Sok. 7/7 Burcak Apt., Bahcelievler, 06500, Ankara, Turkey
| |
Collapse
|
9
|
Moore JC, Zhao X, Nelson EL. Concomitant sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman Disease) and diffuse large B-cell lymphoma: a case report. J Med Case Rep 2008; 2:70. [PMID: 18321383 PMCID: PMC2270859 DOI: 10.1186/1752-1947-2-70] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2007] [Accepted: 03/05/2008] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman Disease, is a rare and benign source of lymphadenopathy first described in 1969, which mimics neoplastic processes. This disease commonly presents in children and young adults with supra-diaphragmatic lymphadenopathy or extranodal lesions consisting of tissue infiltrates composed of a polyclonal population of histiocytes. Since its description greater than 400 cases have been described, sometimes in patients with a variety of treated and untreated neoplastic diseases. However, the literature contains reports of only 19 cases of Rosai-Dorfman Disease in association with lymphomas, Hodgkin's or non-Hodgkin's. The majority of these cases have the two diagnoses, malignant lymphoma and Rosai-Dorfman Disease, separated in time. Interestingly, infradiaphragmatic lymphadenopathy was a feature in the majority of previously reported cases of Rosai-Dorfman Disease and non-Hodgkin's lymphoma. CASE PRESENTATION This report provides details of a case with co-existing sinus histiocytosis with massive lymphadenopathy and diffuse large B cell non-Hodgkin's lymphoma. This case is the fifth described case of simultaneous Rosai-Dorfman Disease and concurrent non-Hodgkin's lymphoma. Unfortunately, the diagnosis of a clinically aggressive diffuse large B cell lymphoma was made at autopsy. The aggressive biological behavior of the diffuse large B cell lymphoma in this patient may have been related to the underlying immune dysregulation believed to be part of the pathophysiology of Rosai-Dorfman Disease. CONCLUSION Taken together this report and the preceding reports of Rosai-Dorfman Disease and non-Hodgkin's lymphoma suggests that in cases with a diagnosis of Rosai-Dorfman Disease in the setting of prominent infradiaphragmatic lymphadenopathy, clinicians should maintain a high index of suspicion for the presence of occult non-Hodgkin's lymphoma especially if the clinical course is atypical for classic Rosai-Dorfman Disease.
Collapse
Affiliation(s)
- James C Moore
- Department of Medicine, Division of Hematology/Oncology, University of California at Irvine, School of Medicine, Irvine, CA, USA.
| | | | | |
Collapse
|
10
|
Long E, Lassalle S, Cheikh-Rouhou R, Hofman V, Lacour JP, Hofman P. Intestinal occlusion caused by Rosai-Dorfman disease mimicking colonic diverticulitis. Pathol Res Pract 2007; 203:233-7. [PMID: 17400399 DOI: 10.1016/j.prp.2007.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2006] [Accepted: 01/10/2007] [Indexed: 11/26/2022]
Abstract
Rosai-Dorfman disease (RDD) involves the gastrointestinal tract only in exceptional cases, and this very unusual site of presentation can confuse the pathologist. We present a case of RDD manifesting as an intestinal occlusion caused by colonic diverticulitis. The patient was a 79-year-old man with myelodysplasia, who presented with fever, abdominal pain, and constipation. Colonoscopy revealed sigmoiditis and diverticulosis. Microscopic study of the sigmoid colon surgical specimen showed the histological and immunological features of RDD. No human DNA of herpesvirus types 6 and 8 (HHV6/HHV8), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) was detected in tissue by polymerase chain reaction. Electron microscopic study revealed no microbes or viral particles. Widespread nodal and extranodal RDD occurred, and the patient died 2y after initial surgery. The etiology of RDD is still under debate. We discuss the association of RDD with hematological disorders.
Collapse
Affiliation(s)
- Elodie Long
- Laboratory of Clinical and Experimental Pathology, 30 avenue de la voie romaine, Louis Pasteur Hospital, 06002 Nice, France
| | | | | | | | | | | |
Collapse
|
11
|
Bernácer-Borja M, Blanco-Rodríguez M, Sanchez-Granados JM, Benitez-Fuentes R, Cazorla-Jimenez A, Rivas-Manga C. Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): clinico-pathological study of three cases. Eur J Pediatr 2006; 165:536-9. [PMID: 16622659 DOI: 10.1007/s00431-006-0133-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2005] [Accepted: 03/08/2006] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We report three cases of sinus histiocytosis, a rare disease of unknown aetiology with massive lymphadenopathy (SHML), also known as Rosai-Dorfman (RD) disease, in a paediatric population. This proliferative histiocytic disorder is defined by histological and immunohistochemical (IHC) characteristics and can manifest as nodal involvement with variable enlargement of the lymph nodes (two cases) and extranodal manifestations involving skin and larynx involvement (one case). One patient had hypergammaglobulinemia. The morphological investigation revealed that all lymph nodes showed hyperplasia of sinuses with abundant histiocytic cell with intracytoplasmic lymphocytes. Skin and larynx biopsies showed a histiocyte and lymphocyte infiltrate with similar characteristics. An ultrastructural study was carried out on material from one patient. In the IHC study, SHML cells expressed phagocytic markers such as CD68 and S100, but markers for Langerhan's (CD1a) or dendritic cells (DRC, CD23 and CNA42) were absent. Two patients had a complete remission after surgical excision and no other treatment, but the third patient was treated with radiotherapy after a relapse with obstruction of the upper airway. CONCLUSION This disorder must be considered in the differential diagnosis of young patients who exhibit massive or multiple lymphadenopathies, especially when involvement of the cervical area occurs. Due to the good outcome of the disease, a conservative approach is justified.
Collapse
Affiliation(s)
- Mercedes Bernácer-Borja
- Paediatric Department, Fundación Jiménez Díaz Hospital, Autonomous University of Madrid, Madrid, Spain
| | | | | | | | | | | |
Collapse
|