Gassel A M, Lamskemper D M, Sold-Darseff J, Müller J G, Müller-Hermelink H K
Institut für Pathologie, Universität Würzburg.
Pathologe. 2004 Sep;25(5):398-401. doi: 10.1007/s00292-004-0691-8.
A case of extranodal sinus histiocytosis with massive lymphadenopathy (ENSHML; Rosai-Dorfman disease) is reported. The patient presented with a history of intracranial tumour and exophthalmus. Clinical examination found a large mass in the left orbit and paranasal sinuses. Excisional biopsy showed a dense fibrous tissue with an infiltrate rich in macrophages. Further evaluation revealed a retroperitoneal mass with consecutive ureteral stenosis. Further histological and immunohistochemical investigation of the orbital mass, now in suspicion of a systemic disease showed an infiltrate of S-100-positive histiocytes and emperipolesis allowing the diagnosis of extranodal sinus histiocytosis. The correct histologic diagnosis was delayed due to the unusual and isolated extranodal localisation of the disease. The literature concerning extranodal manifestations of Rosai-Dorfman disease is reviewed. We suggest the additional evaluation of such rare and unusual cases in experienced reference centers.
报告了1例伴有巨大淋巴结病的结外窦组织细胞增生症(ENSHML;罗萨伊-多夫曼病)。患者有颅内肿瘤和眼球突出病史。临床检查发现左侧眼眶和鼻窦有一个大肿块。切除活检显示为致密纤维组织,伴有富含巨噬细胞的浸润。进一步评估发现腹膜后肿块并伴有连续性输尿管狭窄。对目前怀疑为全身性疾病的眼眶肿块进行进一步的组织学和免疫组化检查,显示有S-100阳性组织细胞浸润及血细胞吞噬现象,从而确诊为结外窦组织细胞增生症。由于该病不寻常的孤立性结外定位,正确的组织学诊断被延迟。本文回顾了关于罗萨伊-多夫曼病结外表现的文献。我们建议在经验丰富的参考中心对这类罕见和不寻常的病例进行进一步评估。