Miniello Thaís Gimenez, Araujo Juliane Piragine, Sugaya Norberto Nobuo, Elias Fernando Melhem, de Almeida Oslei Paes, Alves Fabio Abreu
Stomatology Department - School of Dentistry - Universidade de São Paulo, São Paulo/SP - Brazil .
Oral and Maxillofacial Surgery Department - Faculty of Dentistry - University Hospital - Universidade de São Paulo, São Paulo/SP - Brazil .
Autops Case Rep. 2016 Dec 30;6(4):49-55. doi: 10.4322/acr.2016.057. eCollection 2016 Oct-Dec.
Rosai-Dorfman disease (RDD), formerly called sinus histiocytosis with massive lymphadenopathy, is a non-neoplastic proliferative histiocytic disorder with behavior ranging from highly aggressive to spontaneous remission. Although the lymph nodes are more commonly involved, any organ can be affected. This study aimed to describe the features and the follow-up of a case of extranodal RDD. Our patient was a 39-year-old woman who was referred with an 11-month history of pain in the right maxilla. On clinical examination, some upper right teeth presented full mobility with normal appearance of the surrounding gingiva. Radiographic exams showed an extensive bone reabsorption and maxillary sinus filled with homogeneous tissue, which sometimes showed polypoid formation. An incisional biopsy demonstrated a diffuse inflammatory infiltrate rich in foamy histiocytes displaying lymphocytes emperipolesis. Immunohistochemistry showed positivity for CD68 and S-100, and negativity for CD3, CD20, and CD30. Such features were consistent with the RDD diagnosis. The patient was referred to a hematologist and corticotherapy was administrated for 6 months. RDD is an uncommon disease that rarely affects the maxilla. In the present case, the treatment was conservative, and the patient is currently asymptomatic after 5 years of follow-up.
罗萨伊-多夫曼病(RDD),以前称为伴有巨大淋巴结病的窦性组织细胞增多症,是一种非肿瘤性增殖性组织细胞疾病,其行为从高度侵袭性到自发缓解不等。虽然淋巴结更常受累,但任何器官都可能受到影响。本研究旨在描述一例结外RDD的特征及随访情况。我们的患者是一名39岁女性,因右上颌疼痛11个月前来就诊。临床检查发现,右上颌的一些牙齿完全松动,周围牙龈外观正常。影像学检查显示广泛的骨质吸收,上颌窦充满均匀组织,有时可见息肉样形成。切开活检显示弥漫性炎性浸润,富含显示淋巴细胞入胞现象的泡沫状组织细胞。免疫组化显示CD68和S-100阳性,CD3、CD20和CD30阴性。这些特征与RDD诊断一致。患者被转诊至血液科医生处,并接受了6个月的皮质激素治疗。RDD是一种罕见疾病,很少累及上颌骨。在本病例中,治疗较为保守,经过5年随访,患者目前无症状。