ALK-positive histiocytosis involving the cavernous sinus: A deceptive radiologic mimic of meningioma

Alizadeh, Mohsen; Ravindran, Aishwarya; Chkheidze, Rati; Goyal, Gaurav; Hosseini, Mahdie; Shobeiri, Parnian; Shafieioun, Arezoo; Khalafi, Mohammad; Shahidi, Ramin; Sotoudeh, Houman; Singhal, Aparna

doi:10.1016/j.radcr.2023.03.034

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…Two of three cases located in the intradural extramedullary region revealed a centrally punctate enhancement within the lesion under magnification, resembling mildly/markedly punctate enhancement as presented in other cases. Nevertheless, unlike the relative T2FLAIR hyperintensity observed at the punctate enhancement areas in literature (9,16), this case exhibited T2-hypointense at such punctate enhancement area. Therefore, further investigation is needed to explore their relationship.…”

Section: Discussioncontrasting

confidence: 77%

Imaging features of ALK-positive histiocytosis with neurological involvement: a case report and literature review

Wang,

Zheng,

Xiong

2024

Front. Oncol.

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BackgroundALK-positive histiocytosis is an exceptionally rare neoplasm of histiocytes that predominantly involves the nervous system and can also affect the skin and other parts of the body. Previous relevant literature has provided limited information regarding the imaging manifestations of this disease with neurological involvement.MethodsWe reported a case of ALK-positive histiocytosis with multisystem involvement. Together with a comprehensive literature review, the imaging characteristics of this disease in the nervous system were summarized.ResultsA 3-year-old girl with abdominal pain and ambulation difficulty checked in at the Department of Pediatric Neurology. The initial diagnosis was “acute cerebellitis with ataxia” based on the elevated protein level in the cerebrospinal fluid (CSF). However, despite 3 months of treatment, her condition deteriorated. MRI showed an oval-shaped, intradural extramedullary nodule at the T6–T7 level. The patient was ultimately diagnosed as ALK-positive histiocytosis, accompanied by cauda equina and skin involvement. The literature review showed a total of 23 patients who had involvement of the nervous system and provided imaging descriptions. Together with our case, the imaging features were summarized as follows: iso-dense or slightly hyperdense on computed tomography (CT), isointense or iso-hypointense on T2-weighted imaging (T2WI), moderate homogeneous enhancement with mildly/markedly punctate enhancement or/and smooth ring enhancement on contrast-enhanced T1-weighted imaging (T1WI), restricted diffusion on diffuse weighted imaging (DWI), and elevated fluorodeoxyglucose (FDG) uptake on positron-emission tomography/computed tomography (PET/CT).ConclusionThe multimodal imaging findings of ALK-positive histiocytosis exhibit distinct characteristics, familiarity with which will enhance radiologists’ expertise and facilitate accurate diagnosis of this disease.

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Section: Discussioncontrasting

confidence: 77%

Imaging features of ALK-positive histiocytosis with neurological involvement: a case report and literature review

Wang,

Zheng,

Xiong

2024

Front. Oncol.

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“…Other ALK inhibitors include, but are not limited to, second-generation alectinib, ceritinib, brigatinib, and third-generation lorlatinib. To date, only crizotinib and alectinib have been reported to be effective in APH ( 16 , 31 , 35 ). It is unclear whether TKIs need to be continued for life for the treatment of APH.…”

Section: Discussionmentioning

confidence: 99%

“…Some cases report spontaneous resolution of lesions without any treatment in infants. Most (16,31,35). It is unclear whether TKIs need to be continued for life for the treatment of APH.…”

Section: Discussionmentioning

confidence: 99%

Case report: ALK-positive histiocytosis presented as bilateral synchronous breast masses with long-term remission on crizotinib

Zhou,

Hurtado-Castillo,

Pandey

2023

Front. Med.

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ALK-positive histiocytosis (APH) is a rare type of histiocytic neoplasm with characteristic ALK (Anaplastic Lymphoma Kinase) gene translocation and fusion, with only 27 reported cases in the literature. In this study, we report the first case of synchronous bilateral breast involvement of ALK-positive histiocytosis on initial presentation in a 46-year-old Hispanic woman. APH was diagnosed by the confirmation of clonal histiocyte proliferation with ALK overexpression on IHC and the presence of KIF5B-ALK gene fusion from her breast and lung biopsies. The patient in our study is currently under complete and long-term remission with crizotinib treatment (an ALK inhibitor). This report expands on the clinical manifestation of APH, emphasizes the importance of ALK detection in histiocytic diseases, and provides the efficacy and long-term prognosis of the ALK inhibitor therapy for APH.

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Neuroimaging manifestations of paediatric histiocytoses

Tan,

Lakshmanan,

Warne

et al. 2023

J Med Imag Rad Onc

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SummaryHistiocytoses are rare multi‐system disorders marked by abnormal histiocyte cell proliferation, affecting children with diverse clinical presentations. Classified into five groups in 2016, including Langerhans‐related (L), cutaneous (C), malignant (M), Rosai–Dorfman disease (R) and haemophagocytic lymphohistiocytosis (H), newer entities such as ALK‐positive histiocytosis have also emerged, heralding the era of molecular (sub)classification. Common entities include Langerhans cell histiocytosis (LCH), Erdheim–Chester disease (ECD), Rosai–Dorfman disease (RDD) and haemophagocytic lymphohistiocytosis (HLH). This pictorial essay aids radiologists in recognising and differentiating paediatric histiocytoses based on unique neuroimaging features.

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ALK-positive histiocytosis involving the cavernous sinus: A deceptive radiologic mimic of meningioma

Cited by 3 publications

References 20 publications

Imaging features of ALK-positive histiocytosis with neurological involvement: a case report and literature review

Imaging features of ALK-positive histiocytosis with neurological involvement: a case report and literature review

Case report: ALK-positive histiocytosis presented as bilateral synchronous breast masses with long-term remission on crizotinib

Neuroimaging manifestations of paediatric histiocytoses

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