A rare case of extranodal Rosai-Dorfman disease

Revisiting Rosai Dorfman disease: A rare histiocytic disorder with nodal and extranodal involvement

Rosai Dorfman disease is a rare but benign and self-limiting disorder. A case of Rosai Dorfman disease in a 16-year-old female with classic radiological and pathological findings is presented. T2W hypointense signal of the soft tissue masses was a distinguishing MRI feature.

Contribution

Rosai Dorfman disease is often overlooked in the differentials of lymphadenopathy and soft tissue masses on account of its rarity. This case report comprehensively discusses the imaging approach to this rare disorder.

A report of Rosai-Dorfman disease with systemic multiple lymphadenopathy and high IgG4 plasma cell infiltration

The Rosai-Dorfman disease (RDD) is a kind of sinus histiocytosis with massive lymphadenopathy and is remarkably rare. RDD is characterized by large histiocytes with emperipolesis. However, the cause of RDD is unknown, and most cases are relieved spontaneously. In rare cases, patients may have onset and remission of lymph nodes and extranodal involvement. This report showed an RDD case in a 67-year-old male patient with systemic superficial lymphadenopathy and high IgG4 plasma cell infiltration. We showed that a possible RDD diagnosis should be kept in mind when encountering a systemic multiple lymphadenopathy and high IgG4 plasma cell infiltration. Also, an overlap between RDD and IgG4-related disease might be present, which might help in clinical recognition of RDD.

Rosai-Dorfman disease in Malawi

Rosai-Dorfman Disease (RDD) is a rare lymphoproliferative disease with limited cases reported in sub-Saharan Africa, potentially due to a lack of pathological services throughout the region. RDD diagnosis can be difficult, especially in resource-limited setting, as symptoms can be nearly identical to more common causes of lymphadenopathy.

Multicentric sinus histicytosis (Rosai-Dorfman Disease): Computed tomography, magnetic resonance imaging findings

Sinus histicytosis (Rosai–Dorfman disease) is a rare, benign granulomatous disease that typically presents with massive cervical lymphadenopathy. Extranodal involvement along with concomitant nodal disease occurs in about 43% of cases. We present a unique case of a 30-year-old male with cervical, retroperitoneal lymphadenopathy, associated with renal and pituitary sellar masses.

Rosai-Dorfman disease: A case report with extranodal thyroid involvement

Rosai-Dorfman Disease (RDD) or Sinus Histiocytosis with Massive Lymphadenopathy (SHML) is a rare disorder typically manifesting as enlarged lymph nodes with or without systemic involvement. These cases are often clinically misdiagnosed as lymphoma. Recognising this entity to distinguish it from lymphoma and other causes of histiocytosis is important because of different treatment modalities for these disorders. Extranodal involvement is also common, often with a particular predilection for the head and neck region. We report a rare case of Rosai-Dorfman Disease with both nodal and extranodal involvement in a 33-year-old woman. The patient had bilateral cervical lymphadenopathy and diffuse thyroid enlargement. Thyroid gland involvement in RDD diagnosed on fine needle aspiration cytology (FNAC) has rarely been reported in literature. FNAC is a useful and reliable tool for the diagnosis of RDD and the biopsy can be avoided in these patients, thus reducing inconvenience to patients.

Rosai-Dorfman disease presenting in the oropharynx

BACKGROUND

We report a case of Rosai-Dorfman disease (RDD) presenting as an oropharyngeal mass, and we provide a detailed discussion of this rare clinical entity.

METHODS

An initial biopsy, described as being consistent with lymphoma, was reviewed at a second outside institution and was thought to be reactive lymphoid hyperplasia. The patient then presented to our institution for a second opinion. Direct laryngoscopy revealed a firm 1- to 2-cm lesion involving the left soft palate and superior tonsillar pillar.

RESULTS

The diagnosis of RDD was confirmed with immunohistochemical staining on both cytology and histology. The patient elected conservative management and has remained asymptomatic for over 15 months.

CONCLUSION

The diagnosis of RDD may be challenging in cases presenting initially with extranodal disease. Close follow-up and repeat biopsies may be necessary. Identification of Rosai-Dorfman cells with emperipolesis and confirmation with appropriate immunohistochemical staining on both cytology and histology is diagnostic of RDD. Conservative treatment is appropriate in select cases.

Rosai-Dorfman disease of the subglottis diagnosed by ultrasound-guided fine-needle aspiration biopsy: a case report

We report a case of subglottic narrowing caused by an extranodal deposit of sinus histiocytosis in a 55-year-old man. To the best of our knowledge, no previous reports have described diagnosis using sonographic-guided fine-needle aspiration cytology for Rosai-Dorfman disease of the subglottis. This patient was diagnosed by sonographic-guided fine-needle aspiration biopsy, which revealed lymphocytes, plasma cells, and many foamy, multinuclear histiocytes with preserved lymphocytes in their cytoplasm (emperipolesis). The patient underwent an incisional biopsy of the tumor and received postoperative steroids and low-dose chemotherapy. The subglottic tumor was markedly regressed 6 months later.

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): a clinicoradiological profile of three cases including two with skeletal disease

Originally described as sinus histiocytosis with massive lymphadenopathy, Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disorder with a distinctive microscopic appearance. A rare entity, RDD is often under-diagnosed because of a low index of suspicion by both radiologist and pathologist. Through this article, we wish to apprise radiologists of the spectrum of disease that can be encountered in this disorder. RDD can mimic other common childhood skeletal diseases including benign Langerhans cell histiocytosis and lymphoma. The clinical and radiological manifestations of RDD vary depending upon organ involvement, and its imaging features are often confused with those of other disorders. RDD should be considered in the differential diagnosis of unifocal and multifocal skeletal involvement caused by granulomatous diseases, infections, pseudogranulomatous lesions and malignancy. As long-term outcome is usually good, a conservative approach is justified in most cases. Contrasted with its typical appearance, presenting with bilateral symmetrical cervical adenopathy (as shown in one patient), we also report extranodal involvement of bone in two patients. Extranodal disease occurs along with concomitant nodal disease in about 43% of patients. In 23% of patients, isolated extranodal RDD can be seen, most commonly in the head and neck. In two of our patients, we observed extranodal involvement with skeletal involvement away from the head and neck not associated with lymphadenopathy. Skeletal involvement in RDD without lymphadenopathy is rare, occurring only in 2% of all the patients reported to date.