Skip to main content
Top
Published in: Abdominal Radiology 7/2015

01-10-2015 | Pictorial Essay

Spectrum of abdominal imaging findings in histiocytic disorders

Authors: Natally de Souza Maciel Rocha Horvat, Clovis Rego Coelho, Larissa Cardoso Roza, Rodrigo Canellas de Souza, Yves Bohrer Costa, Ebe Christie de Oliveira, Manoel de Souza Rocha, Ronaldo Hueb Baroni

Published in: Abdominal Radiology | Issue 7/2015

Login to get access

Abstract

Objectives

The present article provides an overview of the spectrum of abdominal findings of histiocytic disorders that may be observed in multimodality imaging illustrated by clinical cases from our Imaging Center.

Methods

We will review abdominal findings of Langerhans cell histiocytosis, Rosai–Dorfman disease, Erdheim–Chester disease, and hemophagocytic syndrome illustrated by clinical cases from our imaging department with histologic correlation.

Results

Abdominal involvement of histiocytic disorders is rare and may occur in the liver, biliary tract, kidney, retroperitoneum, kidney, gastrointestinal tract, and lymph nodes.

Conclusion

Histiocytic disorders encompass a group of rare diseases with a wide range of manifestations in which the abdominal involvement is quite infrequent. The role of the radiologist is to report the major imaging findings and the differential diagnosis; however, the imaging features are unspecific and biopsy usually is necessary to establish the definitive diagnosis.
Literature
1.
go back to reference Favara BE, Feller AC, Pauli M, et al. (1997) Contemporary classification of histiocytic disorders. The WHO Committee On Histiocytic/Reticulum Cell Proliferations. Reclassification Working Group of the Histiocyte Society. Med Pediatr Oncol 29(3):157–166CrossRefPubMed Favara BE, Feller AC, Pauli M, et al. (1997) Contemporary classification of histiocytic disorders. The WHO Committee On Histiocytic/Reticulum Cell Proliferations. Reclassification Working Group of the Histiocyte Society. Med Pediatr Oncol 29(3):157–166CrossRefPubMed
2.
go back to reference Swerdlow SH, Campo E, Harris NL, et al. (2008) WHO classification of tumours of haematopoietic and lymphoid tissues, vol. 2, 4th edn. Lyon: IARC Press Swerdlow SH, Campo E, Harris NL, et al. (2008) WHO classification of tumours of haematopoietic and lymphoid tissues, vol. 2, 4th edn. Lyon: IARC Press
3.
go back to reference Chu T, D'Angio GJ, Favara B, Ladisch S, et al. (1987) Histiocytosis syndromes in children. Writing Group of the Histiocyte Society. Lancet 1(8526):208–209 Chu T, D'Angio GJ, Favara B, Ladisch S, et al. (1987) Histiocytosis syndromes in children. Writing Group of the Histiocyte Society. Lancet 1(8526):208–209
4.
go back to reference Broadbent V, Egeler RM, Nesbit ME Jr (1994) Langerhans cell histiocytosis–clinical and epidemiological aspects. Br J Cancer 23:S11–S16 Broadbent V, Egeler RM, Nesbit ME Jr (1994) Langerhans cell histiocytosis–clinical and epidemiological aspects. Br J Cancer 23:S11–S16
5.
go back to reference Campos MK, Viana MB, de Oliveira BM, Ribeiro DD, Silva CM (2007) Langerhans cell histiocytosis: a 16-year experience. J Pediatr 83(1):79–86 Campos MK, Viana MB, de Oliveira BM, Ribeiro DD, Silva CM (2007) Langerhans cell histiocytosis: a 16-year experience. J Pediatr 83(1):79–86
6.
go back to reference Martin A, Macmillan S, Murphy D, Carachi R (2014) Langerhans cell histiocytosis: 23 years’ paediatric experience highlights severe long-term sequelae. Scott Med J 59(3):149–157CrossRefPubMed Martin A, Macmillan S, Murphy D, Carachi R (2014) Langerhans cell histiocytosis: 23 years’ paediatric experience highlights severe long-term sequelae. Scott Med J 59(3):149–157CrossRefPubMed
7.
go back to reference Alston RD, Tatevossian RG, McNally RJ, et al. (2007) Incidence and survival of childhood Langerhans cell histiocytosis in Northwest England from 1954 to 1998. Pediatr Blood Cancer 48(5):555–560CrossRefPubMed Alston RD, Tatevossian RG, McNally RJ, et al. (2007) Incidence and survival of childhood Langerhans cell histiocytosis in Northwest England from 1954 to 1998. Pediatr Blood Cancer 48(5):555–560CrossRefPubMed
8.
go back to reference Arico M (2004) Langerhans cell histiocytosis in adults: more questions than answers? Eur J Cancer 40(10):1467–1473CrossRefPubMed Arico M (2004) Langerhans cell histiocytosis in adults: more questions than answers? Eur J Cancer 40(10):1467–1473CrossRefPubMed
9.
go back to reference Nicholson HS, Egeler RM, Nesbit ME (1998) The epidemiology of Langerhans cell histiocytosis. Hematol Oncol Clin North Am 12(2):379–384CrossRefPubMed Nicholson HS, Egeler RM, Nesbit ME (1998) The epidemiology of Langerhans cell histiocytosis. Hematol Oncol Clin North Am 12(2):379–384CrossRefPubMed
11.
go back to reference Schmidt S, Eich G, Hanquinet S, et al. (2004) Extra-osseous involvement of Langerhans’ cell histiocytosis in children. Pediatr Radiol 34(4):313–321CrossRefPubMed Schmidt S, Eich G, Hanquinet S, et al. (2004) Extra-osseous involvement of Langerhans’ cell histiocytosis in children. Pediatr Radiol 34(4):313–321CrossRefPubMed
12.
go back to reference Schmidt S, Eich G, Geoffray A, et al. (2008) Extraosseous langerhans cell histiocytosis in children. Radiographics 28(3):707–726CrossRefPubMed Schmidt S, Eich G, Geoffray A, et al. (2008) Extraosseous langerhans cell histiocytosis in children. Radiographics 28(3):707–726CrossRefPubMed
13.
go back to reference Jubran RF, Marachelian A, Dorey F, Malogolowkin M (2005) Predictors of outcome in children with Langerhans cell histiocytosis. Pediatr Blood Cancer 45(1):37–42CrossRefPubMed Jubran RF, Marachelian A, Dorey F, Malogolowkin M (2005) Predictors of outcome in children with Langerhans cell histiocytosis. Pediatr Blood Cancer 45(1):37–42CrossRefPubMed
14.
go back to reference Kim BE, Koh KN, Suh JK, et al. (2014) Clinical features and treatment outcomes of Langerhans cell histiocytosis: a nationwide survey from Korea histiocytosis working party. J Pediatr Hematol Oncol 36(2):125–133CrossRefPubMed Kim BE, Koh KN, Suh JK, et al. (2014) Clinical features and treatment outcomes of Langerhans cell histiocytosis: a nationwide survey from Korea histiocytosis working party. J Pediatr Hematol Oncol 36(2):125–133CrossRefPubMed
15.
go back to reference Lieberman PH, Jones CR, Steinman RM, et al. (1996) Langerhans cell (eosinophilic) granulomatosis. A clinicopathologic study encompassing 50 years. Am J Surg Pathol 20(5):519–552CrossRefPubMed Lieberman PH, Jones CR, Steinman RM, et al. (1996) Langerhans cell (eosinophilic) granulomatosis. A clinicopathologic study encompassing 50 years. Am J Surg Pathol 20(5):519–552CrossRefPubMed
16.
go back to reference McClain KL, Natkunam Y, Swerdlow SH (2004) Atypical cellular disorders. Hematology Am Soc Hematol Educ Program 1:283–296CrossRef McClain KL, Natkunam Y, Swerdlow SH (2004) Atypical cellular disorders. Hematology Am Soc Hematol Educ Program 1:283–296CrossRef
17.
go back to reference Braier J, Ciocca M, Latella A, et al. (2002) Cholestasis, sclerosing cholangitis, and liver transplantation in Langerhans cell Histiocytosis. Med Pediatr Oncol 38(3):178–182CrossRefPubMed Braier J, Ciocca M, Latella A, et al. (2002) Cholestasis, sclerosing cholangitis, and liver transplantation in Langerhans cell Histiocytosis. Med Pediatr Oncol 38(3):178–182CrossRefPubMed
18.
go back to reference Jaffe R (2004) Liver involvement in the histiocytic disorders of childhood. Pediatr Dev Pathol 7(3):214–225CrossRefPubMed Jaffe R (2004) Liver involvement in the histiocytic disorders of childhood. Pediatr Dev Pathol 7(3):214–225CrossRefPubMed
19.
go back to reference Wong A, Ortiz-Neira CL, Reslan WA, et al. (2006) Liver involvement in Langerhans cell histiocytosis. Pediatr Radiol 36(10):1105–1107CrossRefPubMed Wong A, Ortiz-Neira CL, Reslan WA, et al. (2006) Liver involvement in Langerhans cell histiocytosis. Pediatr Radiol 36(10):1105–1107CrossRefPubMed
20.
go back to reference Chan YL, Li CK, Lee CY (1997) Sonographic appearance of hepatic Langerhans cell histiocytosis. Clin Radiol 52(10):761–763CrossRefPubMed Chan YL, Li CK, Lee CY (1997) Sonographic appearance of hepatic Langerhans cell histiocytosis. Clin Radiol 52(10):761–763CrossRefPubMed
21.
go back to reference Kaplan KJ, Goodman ZD, Ishak KG (1999) Liver involvement in Langerhans’ cell histiocytosis: a study of nine cases. Mod Pathol 12(4):370–378PubMed Kaplan KJ, Goodman ZD, Ishak KG (1999) Liver involvement in Langerhans’ cell histiocytosis: a study of nine cases. Mod Pathol 12(4):370–378PubMed
22.
go back to reference Meyer JS, Harty MP, Mahboubi S, et al. (1995) Langerhans cell histiocytosis: presentation and evolution of radiologic findings with clinical correlation. Radiographics 15(5):1135–1146CrossRefPubMed Meyer JS, Harty MP, Mahboubi S, et al. (1995) Langerhans cell histiocytosis: presentation and evolution of radiologic findings with clinical correlation. Radiographics 15(5):1135–1146CrossRefPubMed
23.
go back to reference Egeler RM, Schipper ME, Heymans HS (1990) Gastrointestinal involvement in Langerhans’ cell histiocytosis (Histiocytosis X): a clinical report of three cases. Eur J Pediatr 149(5):325–329CrossRefPubMed Egeler RM, Schipper ME, Heymans HS (1990) Gastrointestinal involvement in Langerhans’ cell histiocytosis (Histiocytosis X): a clinical report of three cases. Eur J Pediatr 149(5):325–329CrossRefPubMed
24.
go back to reference Hyams JS, Haswell JE, Gerber MA, Berman MM (1985) Colonic ulceration in histiocytosis X. J Pediatr Gastroenterol Nutr 4(2):286–290CrossRefPubMed Hyams JS, Haswell JE, Gerber MA, Berman MM (1985) Colonic ulceration in histiocytosis X. J Pediatr Gastroenterol Nutr 4(2):286–290CrossRefPubMed
25.
go back to reference Geissmann F, Thomas C, Emile JF, et al. (1996) Digestive tract involvement in Langerhans cell histiocytosis. The French Langerhans Cell Histiocytosis Study Group. J Pediatr 129(6):836–845CrossRefPubMed Geissmann F, Thomas C, Emile JF, et al. (1996) Digestive tract involvement in Langerhans cell histiocytosis. The French Langerhans Cell Histiocytosis Study Group. J Pediatr 129(6):836–845CrossRefPubMed
26.
go back to reference Sutphen JL, Fechner RE (1986) Chronic gastroenteritis in a patient with histiocytosis-X. J Pediatr Gastroenterol Nutr 5(2):324–328CrossRefPubMed Sutphen JL, Fechner RE (1986) Chronic gastroenteritis in a patient with histiocytosis-X. J Pediatr Gastroenterol Nutr 5(2):324–328CrossRefPubMed
27.
go back to reference Rosai J, Dorfman RF (1969) Sinus histiocytosis with massive lymphadenopathy. A newly recognized benign clinicopathological entity. Arch Pathol 87(1):63–70PubMed Rosai J, Dorfman RF (1969) Sinus histiocytosis with massive lymphadenopathy. A newly recognized benign clinicopathological entity. Arch Pathol 87(1):63–70PubMed
28.
go back to reference Foucar E, Rosai J, Dorfman R (1990) Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): review of the entity. Semin Diagn Pathol 7(1):19–73PubMed Foucar E, Rosai J, Dorfman R (1990) Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): review of the entity. Semin Diagn Pathol 7(1):19–73PubMed
29.
go back to reference Sodhi KS, Suri S, Nijhawan R, Kang M, Gautam V (2005) Rosai-Dorfman disease: unusual cause of diffuse and massive retroperitoneal lymphadenopathy. Br J Radiol 78(933):845–847CrossRefPubMed Sodhi KS, Suri S, Nijhawan R, Kang M, Gautam V (2005) Rosai-Dorfman disease: unusual cause of diffuse and massive retroperitoneal lymphadenopathy. Br J Radiol 78(933):845–847CrossRefPubMed
30.
go back to reference Gaitonde S (2007) Multifocal, extranodal sinus histiocytosis with massive lymphadenopathy: an overview. Arch Pathol Lab Med 131(7):1117–1121PubMed Gaitonde S (2007) Multifocal, extranodal sinus histiocytosis with massive lymphadenopathy: an overview. Arch Pathol Lab Med 131(7):1117–1121PubMed
31.
go back to reference Juskevicius R, Finley JL (2001) Rosai-Dorfman disease of the parotid gland: cytologic and histopathologic findings with immunohistochemical correlation. Arch Pathol Lab Med 125(10):1348–1350PubMed Juskevicius R, Finley JL (2001) Rosai-Dorfman disease of the parotid gland: cytologic and histopathologic findings with immunohistochemical correlation. Arch Pathol Lab Med 125(10):1348–1350PubMed
32.
go back to reference Maric I, Pittaluga S, Dale JK, et al. (2005) Histologic features of sinus histiocytosis with massive lymphadenopathy in patients with autoimmune lymphoproliferative syndrome. Am J Surg Pathol 29(7):903–911CrossRefPubMed Maric I, Pittaluga S, Dale JK, et al. (2005) Histologic features of sinus histiocytosis with massive lymphadenopathy in patients with autoimmune lymphoproliferative syndrome. Am J Surg Pathol 29(7):903–911CrossRefPubMed
33.
go back to reference Lauwers GY, Perez-Atayde A, Dorfman RF, Rosai J (2000) The digestive system manifestations of Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy): review of 11 cases. Hum Pathol 31(3):380–385CrossRefPubMed Lauwers GY, Perez-Atayde A, Dorfman RF, Rosai J (2000) The digestive system manifestations of Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy): review of 11 cases. Hum Pathol 31(3):380–385CrossRefPubMed
34.
go back to reference Esquivel J, Krishnan J, Jundi M, Sugarbaker PH (1999) Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) of the pancreas: first case report. Hepato-gastroenterology 46(26):1202–1205PubMed Esquivel J, Krishnan J, Jundi M, Sugarbaker PH (1999) Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) of the pancreas: first case report. Hepato-gastroenterology 46(26):1202–1205PubMed
35.
go back to reference Zivin SP, Atieh M, Mosier M, Paner GP, Aranha GV (2009) Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) of the pancreas: second case report. J Gastrointest Surg 13(4):806–809CrossRefPubMed Zivin SP, Atieh M, Mosier M, Paner GP, Aranha GV (2009) Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) of the pancreas: second case report. J Gastrointest Surg 13(4):806–809CrossRefPubMed
36.
go back to reference Podberezin M, Angeles R, Guzman G, Peace D, Gaitonde S (2010) Primary pancreatic sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): an unusual extranodal manifestation clinically simulating malignancy. Arch Pathol Lab Med 134(2):276–278PubMed Podberezin M, Angeles R, Guzman G, Peace D, Gaitonde S (2010) Primary pancreatic sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): an unusual extranodal manifestation clinically simulating malignancy. Arch Pathol Lab Med 134(2):276–278PubMed
37.
go back to reference Brown WE, Coakley FV, Heaney M (2002) Renal involvement by Rosai-Dorfman disease: CT findings. Abdom Imaging 27(2):214–216CrossRefPubMed Brown WE, Coakley FV, Heaney M (2002) Renal involvement by Rosai-Dorfman disease: CT findings. Abdom Imaging 27(2):214–216CrossRefPubMed
38.
go back to reference Tabata H, Hisasue S, Tsukamoto T (2012) Extranodal Rosai-Dorfman disease of the kidney and bone. Int J Urol 19(5):486–487CrossRefPubMed Tabata H, Hisasue S, Tsukamoto T (2012) Extranodal Rosai-Dorfman disease of the kidney and bone. Int J Urol 19(5):486–487CrossRefPubMed
39.
go back to reference Alatassi H, Ray MB, Galandiuk S, Sahoo S (2006) Rosai-Dorfman disease of the gastrointestinal tract: report of a case and review of the literature. Int J Surg Pathol 14(1):95–99CrossRefPubMed Alatassi H, Ray MB, Galandiuk S, Sahoo S (2006) Rosai-Dorfman disease of the gastrointestinal tract: report of a case and review of the literature. Int J Surg Pathol 14(1):95–99CrossRefPubMed
40.
go back to reference Chester W (1930) Über lipoid Granulomatose. Virchows Arch Pathol Anat 279:561–602CrossRef Chester W (1930) Über lipoid Granulomatose. Virchows Arch Pathol Anat 279:561–602CrossRef
41.
go back to reference Chetritt J, Paradis V, Dargere D, et al. (1999) Chester-Erdheim disease: a neoplastic disorder. Hum Pathol 30(9):1093–1096CrossRefPubMed Chetritt J, Paradis V, Dargere D, et al. (1999) Chester-Erdheim disease: a neoplastic disorder. Hum Pathol 30(9):1093–1096CrossRefPubMed
42.
go back to reference Al-Quran S, Reith J, Bradley J, Rimsza L (2002) Erdheim-Chester disease: case report, PCR-based analysis of clonality, and review of literature. Mod Pathol 15(6):666–672CrossRefPubMed Al-Quran S, Reith J, Bradley J, Rimsza L (2002) Erdheim-Chester disease: case report, PCR-based analysis of clonality, and review of literature. Mod Pathol 15(6):666–672CrossRefPubMed
43.
go back to reference Surabhi VR, Menias C, Prasad SR, et al. (2008) Neoplastic and non-neoplastic proliferative disorders of the perirenal space: cross-sectional imaging findings. Radiographics 28(4):1005–1017CrossRefPubMed Surabhi VR, Menias C, Prasad SR, et al. (2008) Neoplastic and non-neoplastic proliferative disorders of the perirenal space: cross-sectional imaging findings. Radiographics 28(4):1005–1017CrossRefPubMed
44.
go back to reference Ivan D, Neto A, Lemos L, Gupta A (2003) Erdheim-Chester disease: a unique presentation with liver involvement and vertebral osteolytic lesions. Arch Pathol Lab Med 127(8):e337–e339PubMed Ivan D, Neto A, Lemos L, Gupta A (2003) Erdheim-Chester disease: a unique presentation with liver involvement and vertebral osteolytic lesions. Arch Pathol Lab Med 127(8):e337–e339PubMed
45.
go back to reference Gundling F, Nerlich A, Heitland WU, Schepp W (2007) Biliary manifestation of Erdheim-Chester disease mimicking Klatskin’s carcinoma. Am J Gastroenterol 102(2):452–454CrossRefPubMed Gundling F, Nerlich A, Heitland WU, Schepp W (2007) Biliary manifestation of Erdheim-Chester disease mimicking Klatskin’s carcinoma. Am J Gastroenterol 102(2):452–454CrossRefPubMed
46.
go back to reference Weitzman S (2011) Approach to hemophagocytic syndromes. Hematol Am Soc Hematol Educ Program 2011:178–183CrossRef Weitzman S (2011) Approach to hemophagocytic syndromes. Hematol Am Soc Hematol Educ Program 2011:178–183CrossRef
48.
go back to reference Fitzgerald NE, MacClain KL (2003) Imaging characteristics of hemophagocytic lymphohistiocytosis. Pediatr Radiol 33(6):392–401CrossRefPubMed Fitzgerald NE, MacClain KL (2003) Imaging characteristics of hemophagocytic lymphohistiocytosis. Pediatr Radiol 33(6):392–401CrossRefPubMed
49.
go back to reference Nakatsuka A, Wada J, Nagase R, et al. (2007) Hemophagocytic syndrome associated with fatal veno-occlusive disease in the liver. Intern Med 46(8):495–499CrossRefPubMed Nakatsuka A, Wada J, Nagase R, et al. (2007) Hemophagocytic syndrome associated with fatal veno-occlusive disease in the liver. Intern Med 46(8):495–499CrossRefPubMed
50.
go back to reference Wilejto M, Abla O (2012) Langerhans cell histiocytosis and Erdheim-Chester disease. Curr Opin Rheumatol 24(1):90–96CrossRefPubMed Wilejto M, Abla O (2012) Langerhans cell histiocytosis and Erdheim-Chester disease. Curr Opin Rheumatol 24(1):90–96CrossRefPubMed
Metadata
Title
Spectrum of abdominal imaging findings in histiocytic disorders
Authors
Natally de Souza Maciel Rocha Horvat
Clovis Rego Coelho
Larissa Cardoso Roza
Rodrigo Canellas de Souza
Yves Bohrer Costa
Ebe Christie de Oliveira
Manoel de Souza Rocha
Ronaldo Hueb Baroni
Publication date
01-10-2015
Publisher
Springer US
Published in
Abdominal Radiology / Issue 7/2015
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-015-0449-1

Other articles of this Issue 7/2015

Abdominal Radiology 7/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine