Radiology-pathology correlation: Rosai-Dorfman disease

Area of Science:

• Neuropathology
• Neuroradiology
• Oncology

Background:

• Rosai-Dorfman Disease (RDD), or sinus histiocytosis with massive lymphadenopathy, is a rare non-Langerhans cell histiocytic neoplasm.
• While typically presenting as lymphadenopathy, RDD can manifest in the central nervous system (CNS), causing symptoms like headaches and neurological deficits.
• CNS RDD lesions often mimic meningiomas on imaging, presenting as dural-based masses with dural tails.

Purpose of the Study:

• To highlight key clinical, imaging, and pathological features of CNS Rosai-Dorfman Disease.
• To provide neuroradiologists with essential information for recognizing CNS RDD.
• To differentiate CNS RDD from other dural-based lesions.

Main Methods:

• Review of a case of CNS Rosai-Dorfman Disease.
• Analysis of clinical presentation, neuroimaging findings (MRI/CT), and histopathological results.
• Correlation of radiological features with pathological diagnosis.

Main Results:

• CNS RDD presents as well-circumscribed, dural-based masses, frequently with dural tails, similar to meningiomas.
• Specific imaging clues can suggest RDD, aiding in differential diagnosis before definitive histopathology.
• Pathological examination reveals characteristic findings of Rosai-Dorfman Disease in CNS lesions.

Conclusions:

• Accurate diagnosis of CNS RDD relies on integrating clinical, imaging, and pathological data.
• Recognizing subtle imaging differences can help distinguish CNS RDD from more common mimics like meningiomas.
• This radiology-pathology report enhances understanding and diagnostic accuracy for CNS RDD.