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Erdheim-Chester Disease with Emperipolesis: A Unique Case Involving the Heart

Histiocytosis is an uncommon disease characterized by excessive accumulation of histiocytes. Here, we report a rare case of non-Langerhans-cell histiocytosis in a 51-year-old woman who presented with severe symptoms of pericardial effusion. Radiologic investigation also detected multiple bone (lower...

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Detalles Bibliográficos
Autores principales: Zhu, Pengcheng, Li, Naping, Yu, Lu, Miranda, Mariajose Navia, Wang, Guoping, Duan, Yaqi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Cancer Association 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398381/
https://www.ncbi.nlm.nih.gov/pubmed/27488869
http://dx.doi.org/10.4143/crt.2016.078
Descripción
Sumario:Histiocytosis is an uncommon disease characterized by excessive accumulation of histiocytes. Here, we report a rare case of non-Langerhans-cell histiocytosis in a 51-year-old woman who presented with severe symptoms of pericardial effusion. Radiologic investigation also detected multiple bone (lower limbs, vertebrae, ribs, and ilium) lesions. Resected pericardium showed abundant mono- or multi-nucleated non-foamy histiocytes (CD68(+)/CD163(+)/S-100(+)/CD1α(−)/langerin(−)) in a fibroinflammatory background. The histiocytes demonstrated emperipolesis of lymphocytes, a hallmark feature of Rosai-Dorfman disease (RDD). However, molecular analysis revealed a BRAF V600E mutation of the proliferating histiocytes, highlighting the neoplastic features frequently observed in another non-Langerhans-cell histiocytosis known as Erdheim-Chester Disease (ECD). We consider this case to be a unique presentation of ECD harboring some RDD-like cells with emperipolesis, but not a case of RDD with a BRAF mutation concerning its clinical manifestation (involvement of the heart and bones) and neoplastic features.