title: Redefining the Prevalence of Dural Involvement in Rosai-Dorfman Disease of the Central Nervous System.
abstract: BACKGROUND
  Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease, is a rare condition, classically characterized by painless, massive cervical lymphadenopathy. Histologically, the pathognomonic findings include a dense, mixed inflammatory infiltrate with areas of emperipolesis. Albeit infrequent, when Rosai-Dorfman disease affects the central nervous system, it typically manifests as an isolated dural lesion, often mimicking a meningioma. A purely intraparenchymal manifestation of Rosai-Dorfman disease of the brain and spine with absent dural involvement is exceedingly rare.
  
  
  METHODS
  In this report, we describe a 59-year-old woman who underwent surgical excision of an intraparenchymal cerebellar lesion. Histologic analysis of the resected specimen diagnosed isolated Rosai-Dorfman disease with absent systemic involvement. We also provide an updated review of the literature of nondural-based Rosai-Dorfman disease in the central nervous system.
  
  
  CONCLUSIONS
  With the recent increase of such reported cases, it becomes imperative that Rosai-Dorfman be considered more than as a dural lesion that may mimic meningioma. Diagnostic and therapeutic challenges surrounding this disease entity are also discussed.
authors.affiliation: College of Medicine, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hong
authors.affiliation: Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA. Electronic address: bobby.starke@gmail.com.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Starke
authors.affiliation: Department of Pathology, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Hays
authors.affiliation: Department of Pathology, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Mandell
authors.affiliation: Department of Neurology, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: David
authors.initials: D
authors.lastname: Schiff
authors.affiliation: Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Ashok R
authors.initials: AR
authors.lastname: Asthagiri
mesh_terms: D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D003937:Diagnosis, Differential; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D015618:Histiocytosis, Sinus / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: Cerebral; Inflammatory sinus histiocytosis; Intracranial; Rosai-Dorfman