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The Breast
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
It has been claimed by Black and associates35 that sinus histiocytosis within regional lymph nodes has a favorable prognosis due to favorable immunological response. However, this has not been confirmed. In addition, our data suggest that the presence of a high peripheral lymphocyte count in the patients prior to therapy may carry good prognosis.
The lymphoreticular system and bone marrow
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Sinus histiocytosis – a proliferation of histiocytes in the sinuses – is a common reaction most often seen in nodes draining malignant tumours. Reactions with increased histiocytes within the nodal parenchyma are usually related to foreign material or cellular debris. Accumulation of anthracotic carbon pigment is prominent within the mediastinal and hilar nodes of older city dwellers due to soot inhalation. Other materials that produce these reactions include silicone used in artificial finger joints and breast implants. In dermatopathic lymphadenopathy, lymph nodes that are involved in draining skin disorders – especially lichenoid conditions and mycosis fungoides (see Chapter 19) – may be considerably enlarged due to the paracortical proliferation of Langerhans’ cells and histiocytes containing melanin pigment. This is an entirely benign reaction, but, in cases of T-cell lymphoma, small numbers of malignant cells can be present in such a pattern and should be looked for diligently.
Lymph Node
Published in Joseph Kovi, Hung Dinh Duong, Frozen Section In Surgical Pathology: An Atlas, 2019
Joseph Kovi, M.D. Hung Dinh Duong
Metastatic tumor cells lodging in the subcapsular, cortical, or medullary sinuses must be differentiated from reactive sinus histiocytosis. Sinus histiocytosis is an extremely common condition and is encountered in lymph nodes draining inflammatory foci. In contrast to the conventional paraffin sections there is no noticeable shrinkage effect present in frozen sections. Therefore, even the harmless sinus histiocytes may appear large and somewhat atypical. For differential diagnosis of metastatic carcinoma and sinus histiocytosis, see the section on microscopic differential diagnosis of sinus histiocytosis.* It is important to distinguish metastatic carcinoma from benign glandular lymph node inclusions found in abdominal paraaortic and pelvic lymph nodes.106–108 Benign glandular inclusions are encountered in frozen sections of lymph nodes from middle-aged patients who are undergoing abdominal surgery. These inclusions are generally few in number and the cytologic appearance of the epithelial cells lining the usually dilated glandular structures is entirely benign.108
Rosai-Dorfman disease in a symptomatic elderly man
Published in Baylor University Medical Center Proceedings, 2022
Gaurav Synghal, Risha Bhavan, Sharad K. Jain, Umesh D. Oza
An 81-year-old man presented to a hematologist with fatigue, a 10-pound weight loss, and laboratory findings suggesting anemia of chronic disease with elevated ferritin, decreased total iron binding capacity, decreased iron, and a low-normal iron percent saturation. The patient had multiple negative stool guaiac tests to rule out underlying colon carcinoma. He was started on iron and B12 supplementation, and a bone marrow biopsy showed a normocellular marrow with trilineage hematopoiesis. At the same time, the patient visited his urologist due to persistent urinary tract infections; computed tomography (CT) showed large retroperitoneal lymphadenopathy and soft tissue density infiltrating the kidneys (Figure 1a, 1b). Additional workup revealed an enlarged 3.8 cm supraclavicular lymph node amenable to surgical excision. Upon histopathologic and immunohistochemical evaluation, the lymph node demonstrated marked sinus histiocytosis with co-expression of S100 and CD68, suggesting RDD. Next-generation sequencing demonstrated no targetable mutations, 5% positive PD-L1 expression, and lack of PDGFRA expression. Positron emission tomography (PET)/CT helped evaluate the full extent of the patient’s disease burden (Figure 1c). The patient was started on corticosteroids with subsequent symptomatic improvement, stable hemoglobin, and improving adenopathy over the course of 12 months of follow-up.
Cranio-spinal Rosai Dorfman disease: case series and literature review
Published in British Journal of Neurosurgery, 2019
Shashank S. Joshi, Shilpa Joshi, Girish Muzumdar, Keki E. Turel, Rajan M. Shah, Indoo Ammbulkar, Muhammad Masood Hussain, Kishor A. Choudhari
Rosai-Dorfman disease (RDD) is a lymphoma-like condition, commonly presenting as cervical lymphadenopathy in young adults. Extra-nodal involvement affecting skin, para-nasal sinuses, soft tissue, bone, salivary glands and oral cavity is relatively common. Cranio-spinal lesions are uncommon and cerebral parenchymal involvement is rare. Clinical presentation in craniospinal disease is similar to other space occupying lesion and the diagnosis is mostly histopathological since radiological signs have a limited role. Rosai Dorfman disease (RDD) was described as a new entity by Juan Rosai and Ronald Dorfman in 1969.1 It is also known as Destombes-Rosai-Dorfman disease as it was retrospectively realised that Pierre-Paul Louis Lucien Destombes, a french pathologist had already described this entity in 1965.2 Juan Rosai was an Italian born pathologist and Ronald Dorfman, a South African pathologist. They referred to the term ‘malignant reticulo-endotheliosis’ as a frequently used ‘waste-bin’ diagnosis, and decided to run a project on this subject. A retrospective analysis of similar cases was performed, where in four cases they realised that even if it was labelled as a malignant condition all these patients remained well for several years after the diagnosis and that it was in fact a relatively benign condition. Their initial study comprised of only four such cases and they termed it 'sinus histiocytosis with massive lymphadenopathy'. Their second paper which comprised of a larger sample size of 34 cases, referred by various pathologist and the condition was then named after them.3 The aim of this study was to review the clinical and radiological characteristics and management of five case, and review the literature of this rare disease.