CT and MRI analysis of central nervous system Rosai-Dorfman disease

Objective: To study the CT and MRI imaging features of central nervous system Rosai-Dorfman disease and to enhance knowledge and differential diagnostic ability for central nervous system Rosai-Doffman disease. Methods: The CT and MRI imaging appearances in 4 cases of pathologically proven Rosai-Dorfman disease were retrospectively evaluated and the literature of central nervous system Rosai- Dorfman disease were reviewed. Results: Two cases had cranial CT scans, 4 cases had cranial MRI scans. On CT scans, cerebral edema was demonstrated in one case and the other case was normal. MRI scans showed the lesions were solitary in saddle area in 3 cases, and multiple in anterior cranial fossa in 1 case. The lesions exhibited iso- to hypointensity on both T1WI and T2WI images. Following intravenous injection of contrast medium, ring-like enhancement was seen in 2 cases and homogeneous enhancement in 1 case. Nodular enhancement was seen in the case of multiple lesions in the anterior cranial fossa. All lesions were dural-based. Conclusions: In patients with fever, headache, elevation of the erythrocyte sedimentation rate (ESR) and a polyclonal increase in γ-globulins, the possibility of central nervous system Rosai-Dorfman disease should be considered when single or multiple dural-based mass lesions, especially in sellar region, were identified by CT and MRI. (authors)