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颅-脊髓型罗萨伊-多夫曼病:病例系列及文献综述

Cranio-spinal Rosai Dorfman disease: case series and literature review.

作者信息

Joshi Shashank S, Joshi Shilpa, Muzumdar Girish, Turel Keki E, Shah Rajan M, Ammbulkar Indoo, Hussain Muhammad Masood, Choudhari Kishor A

机构信息

a Department of Neurosurgery , Hindu Rhiday Samrat Balasaheb Thakare Medical College & Dr R N Cooper Hospital , Mumbai , Maharashtra , India.

b Department of Neurosurgery , Sevenhills Hospital , Mumbai , Maharashtra , India.

出版信息

Br J Neurosurg. 2019 Apr;33(2):176-183. doi: 10.1080/02688697.2017.1329517. Epub 2017 May 22.

DOI:10.1080/02688697.2017.1329517
PMID:28532172
Abstract

Rosai-Dorfman disease (RDD) is a rare condition similar to lymphomas, presenting with cervical lymphadenopathy in young adults. Extra-nodal involvement is relatively common but involvement of the central nervous system (CNS) is rare. Cranial RDD presents with symptoms of raised intracranial pressure, focal or generalised seizures, while spinal RDD presents with pain, peripheral neurological deficits and radiculopathy. In contrast to other similar neoplastic or degenerative conditions affecting the CNS, RDD is a benign, non-infective, granulomatous disorder. Radiologically cranio-spinal RDD often mimics commoner dural-based lesions like meningioma, with only subtle radiological differentiating findings on Magnetic Resonance Imaging (MRI). The histopathology of RDD is diagnostic. Surgical excision is preferred modality of treatment. However, adjuvant therapies like steroids and radiation may help controlling residual or recurrent disease. There are multiple sporadic reports and short case publications in the literature, often focusing on a particular aspect of RDD. In this study, authors aim to present five cases of craniospinal RDD, and comprehensive review of literature and highlight neurological complications of systemic RDD.

摘要

罗萨伊-多夫曼病(RDD)是一种罕见疾病,类似于淋巴瘤,多见于年轻成年人,表现为颈部淋巴结肿大。结外受累相对常见,但中枢神经系统(CNS)受累罕见。颅骨RDD表现为颅内压升高、局灶性或全身性癫痫发作症状,而脊柱RDD表现为疼痛、周围神经功能缺损和神经根病。与其他影响中枢神经系统的类似肿瘤性或退行性疾病不同,RDD是一种良性、非感染性的肉芽肿性疾病。在放射学上,颅脊髓RDD常模仿更常见的硬膜下病变,如脑膜瘤,在磁共振成像(MRI)上只有细微的放射学鉴别表现。RDD的组织病理学具有诊断意义。手术切除是首选的治疗方式。然而,类固醇和放疗等辅助治疗可能有助于控制残留或复发性疾病。文献中有多篇散在报道和简短病例出版物,通常聚焦于RDD的某个特定方面。在本研究中,作者旨在介绍5例颅脊髓RDD病例,并对文献进行全面综述,突出系统性RDD的神经并发症。

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