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Extranodal Rosai-Dorfman Disease Involving the Left Atrium: Cardiac MRI, CT, and PET Scan Findings.

Daruwalla VJ, Parekh K, Tahir H, Collins JD, Carr J - Case Rep Radiol (2015)

Bottom Line: Rosai-Dorfman disease (RDD) is a rare entity that usually involves the lymph nodes but extranodal involvements have been seen in numerous cases, although RDD with cardiovascular involvement is extremely rare.We describe a case of a young male who presented with intermittent palpitations and was found to have a left atrium mass.RDD should be considered as one of the differentials even for isolated cardiac lesions.

View Article: PubMed Central - PubMed

Affiliation: Conemaugh Memorial Hospital/Temple University, 1199 Mckinley Avenue, Johnstown, PA 15905, USA.

ABSTRACT
Rosai-Dorfman disease (RDD) is a rare entity that usually involves the lymph nodes but extranodal involvements have been seen in numerous cases, although RDD with cardiovascular involvement is extremely rare. We describe a case of a young male who presented with intermittent palpitations and was found to have a left atrium mass. Our case not only emphasizes the rarity of the above lesion but also highlights the importance of modern-day imaging like computed tomography, Cardiac Magnetic Resonance Imaging (CMRI), and PET scan in characterizing such nonspecific lesions and directing appropriate line of treatment. RDD should be considered as one of the differentials even for isolated cardiac lesions.

No MeSH data available.


Related in: MedlinePlus

Cardiac MR (CMR) with and without contrast. T1 weighted dark blood image on 4-chamber view showed an isointense mass in left atrium with wall thickening along its posterior wall (a). Infiltrative nature of mass is noted in the form of hyperintense thickening of posterior wall of left atrium on T2 weighted dark blood image on 4-chamber view (b). Central T2 hypointensity, which is a common finding in RDD, can be seen in our case (c). Homogenous postcontrast enhancement is seen on delayed postcontrast 4-chamber view. Mediastinal lymphadenopathy with similar signal intensity as cardiac mass is seen on fat-suppressed postcontrast axial image (d). Lymphadenopathy is more marked in aortopulmonary window station.
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fig1: Cardiac MR (CMR) with and without contrast. T1 weighted dark blood image on 4-chamber view showed an isointense mass in left atrium with wall thickening along its posterior wall (a). Infiltrative nature of mass is noted in the form of hyperintense thickening of posterior wall of left atrium on T2 weighted dark blood image on 4-chamber view (b). Central T2 hypointensity, which is a common finding in RDD, can be seen in our case (c). Homogenous postcontrast enhancement is seen on delayed postcontrast 4-chamber view. Mediastinal lymphadenopathy with similar signal intensity as cardiac mass is seen on fat-suppressed postcontrast axial image (d). Lymphadenopathy is more marked in aortopulmonary window station.

Mentions: A 27-year-old African American male without any significant past medical history presented with intermittent palpitations and left ventricular hypertrophy on electrocardiogram (ECG). Two-dimensional (2D) transthoracic echocardiography showed an echodense mass in the left atrium. Further evaluation with Cardiac Magnetic Resonance Imaging (CMRI) demonstrated a heterogeneous broad base mass arising from the posterior superior wall and roof of the left atrium. The mass was located approximately at the expected location of coumadin ridge and measured 1.9 × 1.5 cm and demonstrated mild postcontrast enhancement (Figure 2). It arises from a diffusely thickened superior posterior wall and atrial roof but did not obstruct the pulmonary venous drainage at this time. Mediastinal lymphadenopathy with similar signal intensity as cardiac mass was noted on fat-suppressed postcontrast axial images (Figure 1). Lymphadenopathy was more marked in aortopulmonary region.


Extranodal Rosai-Dorfman Disease Involving the Left Atrium: Cardiac MRI, CT, and PET Scan Findings.

Daruwalla VJ, Parekh K, Tahir H, Collins JD, Carr J - Case Rep Radiol (2015)

Cardiac MR (CMR) with and without contrast. T1 weighted dark blood image on 4-chamber view showed an isointense mass in left atrium with wall thickening along its posterior wall (a). Infiltrative nature of mass is noted in the form of hyperintense thickening of posterior wall of left atrium on T2 weighted dark blood image on 4-chamber view (b). Central T2 hypointensity, which is a common finding in RDD, can be seen in our case (c). Homogenous postcontrast enhancement is seen on delayed postcontrast 4-chamber view. Mediastinal lymphadenopathy with similar signal intensity as cardiac mass is seen on fat-suppressed postcontrast axial image (d). Lymphadenopathy is more marked in aortopulmonary window station.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4477210&req=5

fig1: Cardiac MR (CMR) with and without contrast. T1 weighted dark blood image on 4-chamber view showed an isointense mass in left atrium with wall thickening along its posterior wall (a). Infiltrative nature of mass is noted in the form of hyperintense thickening of posterior wall of left atrium on T2 weighted dark blood image on 4-chamber view (b). Central T2 hypointensity, which is a common finding in RDD, can be seen in our case (c). Homogenous postcontrast enhancement is seen on delayed postcontrast 4-chamber view. Mediastinal lymphadenopathy with similar signal intensity as cardiac mass is seen on fat-suppressed postcontrast axial image (d). Lymphadenopathy is more marked in aortopulmonary window station.
Mentions: A 27-year-old African American male without any significant past medical history presented with intermittent palpitations and left ventricular hypertrophy on electrocardiogram (ECG). Two-dimensional (2D) transthoracic echocardiography showed an echodense mass in the left atrium. Further evaluation with Cardiac Magnetic Resonance Imaging (CMRI) demonstrated a heterogeneous broad base mass arising from the posterior superior wall and roof of the left atrium. The mass was located approximately at the expected location of coumadin ridge and measured 1.9 × 1.5 cm and demonstrated mild postcontrast enhancement (Figure 2). It arises from a diffusely thickened superior posterior wall and atrial roof but did not obstruct the pulmonary venous drainage at this time. Mediastinal lymphadenopathy with similar signal intensity as cardiac mass was noted on fat-suppressed postcontrast axial images (Figure 1). Lymphadenopathy was more marked in aortopulmonary region.

Bottom Line: Rosai-Dorfman disease (RDD) is a rare entity that usually involves the lymph nodes but extranodal involvements have been seen in numerous cases, although RDD with cardiovascular involvement is extremely rare.We describe a case of a young male who presented with intermittent palpitations and was found to have a left atrium mass.RDD should be considered as one of the differentials even for isolated cardiac lesions.

View Article: PubMed Central - PubMed

Affiliation: Conemaugh Memorial Hospital/Temple University, 1199 Mckinley Avenue, Johnstown, PA 15905, USA.

ABSTRACT
Rosai-Dorfman disease (RDD) is a rare entity that usually involves the lymph nodes but extranodal involvements have been seen in numerous cases, although RDD with cardiovascular involvement is extremely rare. We describe a case of a young male who presented with intermittent palpitations and was found to have a left atrium mass. Our case not only emphasizes the rarity of the above lesion but also highlights the importance of modern-day imaging like computed tomography, Cardiac Magnetic Resonance Imaging (CMRI), and PET scan in characterizing such nonspecific lesions and directing appropriate line of treatment. RDD should be considered as one of the differentials even for isolated cardiac lesions.

No MeSH data available.


Related in: MedlinePlus