Rosai-Dorfman disease of the subdural spine with a long segment lesion: A case report and literature review

J Int Med Res. 2017 Apr;45(2):875-881. doi: 10.1177/0300060516687228. Epub 2017 Feb 8.

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.

Keywords: Rosai-Dorfman disease; case report; sinus histiocytosis; spine involvement.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antigens, CD / genetics
  • Antigens, CD / metabolism
  • Antigens, CD1 / genetics
  • Antigens, CD1 / metabolism
  • Antigens, Differentiation, Myelomonocytic / genetics
  • Antigens, Differentiation, Myelomonocytic / metabolism
  • Biomarkers / metabolism
  • Gene Expression
  • Histiocytosis, Sinus / diagnostic imaging
  • Histiocytosis, Sinus / metabolism
  • Histiocytosis, Sinus / pathology*
  • Histiocytosis, Sinus / surgery
  • Humans
  • Lymphadenopathy / diagnostic imaging
  • Lymphadenopathy / metabolism
  • Lymphadenopathy / pathology*
  • Lymphadenopathy / surgery
  • Magnetic Resonance Imaging
  • Male
  • Prognosis
  • S100 Proteins / genetics
  • S100 Proteins / metabolism
  • Spine / diagnostic imaging
  • Spine / innervation
  • Spine / metabolism
  • Spine / pathology*
  • Spine / surgery
  • Subdural Space / diagnostic imaging
  • Subdural Space / metabolism
  • Subdural Space / pathology*
  • Subdural Space / surgery

Substances

  • Antigens, CD
  • Antigens, CD1
  • Antigens, Differentiation, Myelomonocytic
  • Biomarkers
  • CD1a antigen
  • CD68 antigen, human
  • S100 Proteins