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Hartmann T, Solomon N, Lerner G, Ehrlich L. Rosai-Dorfman Disease in a Pediatric Patient: Imaging Findings and Pathology with a brief review of the Literature. J Radiol Case Rep 2023; 17:1-14. [PMID: 38098961 PMCID: PMC10718311 DOI: 10.3941/jrcr.v17i8.4873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Rosai-Dorfman Disease, otherwise known as sinus histiocytosis with massive lymphadenopathy, is a rare form of non-Langerhans cell histiocytosis with an estimated incidence of 100 cases per year in the United States. Due to its variable presentation and nonspecific clinical findings, it is particularly difficult to diagnose in pediatric patients. We report a case of an 11-month-old male who presented with a 4-day history of a right groin mass. Ultrasound of the groin and pelvis demonstrated, and MRI of the abdomen and pelvis confirmed an inguinal mass with surrounding lymphadenopathy. Pathology confirmed Rosai-Dorfman Disease and the patient improved after starting oral steroid therapy. To the best of our knowledge, this is the first case of Rosai-Dorfman Disease involving the inguinal region in an infant under 1 year of age reported in the literature. In this case report, we discuss the imaging and histology findings as well as provide a brief literature review for this diagnosis.
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Affiliation(s)
- Thomas Hartmann
- Medical Student, University of Central Florida College of Medicine, Orlando, USA
| | - Nadia Solomon
- Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, USA
| | - Gabriel Lerner
- Department of Pathology and Laboratory Medicine, Yale New Haven Hospital, New Haven, USA
| | - Lauren Ehrlich
- Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, USA
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Murad V, Cheon GJ. Rosai-Dorfman Disease: Importance of 18F FDG PET/CT to Determine Extension and Extranodal Involvement. Nucl Med Mol Imaging 2021; 55:146-148. [PMID: 34093894 DOI: 10.1007/s13139-021-00683-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 10/22/2022] Open
Abstract
Rosai-Dorfman disease or sinus histiocytosis with lymphadenopathy is a rare benign histiocytic proliferative disorder of unknown etiology first described in 1969. It typically affects older females and most common presentation is with massive lymphadenopathy and nonspecific systemic symptoms; therefore, it is often confused with lymphoproliferative disorders [1, 2]. We present the case of a 69-year-old woman with nasal obstruction as only complaint. Laboratory tests showed normal leukocyte count with elevated ANC (absolute neutrophil count), normal RBC count with normal MCV (mean corpuscular volume) and MCH (mean corpuscular hemoglobin), elevated ESR (erythrocyte sedimentation rate), and normal IgG, IgA, and IgM values. Evaluation revealed a nasopharyngeal mass, which was biopsied and reported emperipolesis with positive CD68 and S-100; typical and differential findings of this disease [1, 2]. 18F FDG PET/CT was performed to determine the extent and involvement of the disease. Considering the presence of few symptoms and no significant laboratory abnormality, treating physicians decided to start a regimen of corticosteroids (prednisolone) for a period of 4 months, after which a follow-up with 18F FDG PET/CT will be performed.
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Affiliation(s)
- Vanessa Murad
- Department of Nuclear Medicine, College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, College of Medicine, Seoul National University Hospital, Seoul, South Korea
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Amiji I, Mohammed U, Salum H, Karugaba E, Mkeni L, Mumburi L, Msafiri A, Massawe H. Rosai Dorfman Disease -A rare case of cervical lymphadenopathy. Clin Case Rep 2020; 8:2712-2715. [PMID: 33363810 PMCID: PMC7752541 DOI: 10.1002/ccr3.3255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/01/2020] [Indexed: 02/03/2023] Open
Abstract
Rosai Dorfman disease is a rare cause of sinus histiocytosis with massive lymphadenopathy. In developing countries, it often mimics some infectious diseases and malignancies and is often mismanaged. A high index of suspicion is necessary for its diagnosis. It is seldom life threatening therefore observation is currently the best advocated approach for its management.
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Affiliation(s)
- Insiyah Amiji
- Department of Paediatric and Child HealthSchool of MedicineMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| | - Ummulkheir Mohammed
- Department of Paediatric and Child HealthSchool of MedicineMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| | - Hajaj Salum
- Department of Paediatric and Child HealthSchool of MedicineMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| | - Emilia Karugaba
- Department of Paediatric and Child HealthSchool of MedicineMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| | - Luka Mkeni
- Department of Paediatric and Child HealthSchool of MedicineMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
- Department of PaediatricMuhimbili National HospitalDar es SalaamTanzania
| | - Livin Mumburi
- Department of PaediatricMuhimbili National HospitalDar es SalaamTanzania
| | - Anna Msafiri
- Department of PaediatricMuhimbili National HospitalDar es SalaamTanzania
| | - Higgins Massawe
- Department of PaediatricMuhimbili National HospitalDar es SalaamTanzania
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Miniello TG, Araujo JP, Sugaya NN, Elias FM, de Almeida OP, Alves FA. Rosai-Dorfman disease affecting the maxilla. Autops Case Rep 2017; 6:49-55. [PMID: 28210574 PMCID: PMC5304562 DOI: 10.4322/acr.2016.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 11/28/2016] [Indexed: 11/23/2022] Open
Abstract
Rosai-Dorfman disease (RDD), formerly called sinus histiocytosis with massive lymphadenopathy, is a non-neoplastic proliferative histiocytic disorder with behavior ranging from highly aggressive to spontaneous remission. Although the lymph nodes are more commonly involved, any organ can be affected. This study aimed to describe the features and the follow-up of a case of extranodal RDD. Our patient was a 39-year-old woman who was referred with an 11-month history of pain in the right maxilla. On clinical examination, some upper right teeth presented full mobility with normal appearance of the surrounding gingiva. Radiographic exams showed an extensive bone reabsorption and maxillary sinus filled with homogeneous tissue, which sometimes showed polypoid formation. An incisional biopsy demonstrated a diffuse inflammatory infiltrate rich in foamy histiocytes displaying lymphocytes emperipolesis. Immunohistochemistry showed positivity for CD68 and S-100, and negativity for CD3, CD20, and CD30. Such features were consistent with the RDD diagnosis. The patient was referred to a hematologist and corticotherapy was administrated for 6 months. RDD is an uncommon disease that rarely affects the maxilla. In the present case, the treatment was conservative, and the patient is currently asymptomatic after 5 years of follow-up.
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Affiliation(s)
- Thaís Gimenez Miniello
- Stomatology Department - School of Dentistry - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Juliane Piragine Araujo
- Stomatology Department - School of Dentistry - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Norberto Nobuo Sugaya
- Stomatology Department - School of Dentistry - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Fernando Melhem Elias
- Oral and Maxillofacial Surgery Department - Faculty of Dentistry - University Hospital - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Oslei Paes de Almeida
- Oral Pathology Department - School of Dentistry of Piracicaba - Universidade de Campinas, Piracicaba/SP - Brazil
| | - Fabio Abreu Alves
- Stomatology Department - AC Camargo Cancer Center, São Paulo/SP - Brazil
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di Dio F, Mariotti I, Coccolini E, Bruzzi P, Predieri B, Iughetti L. Unusual presentation of Rosai-Dorfman disease in a 14-month-old Italian child: a case report and review of the literature. BMC Pediatr 2016; 16:62. [PMID: 27142277 PMCID: PMC4855344 DOI: 10.1186/s12887-016-0595-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 04/21/2016] [Indexed: 01/16/2023] Open
Abstract
Background Rosai-Dorfman disease (RDD) is a rare form of histiocytosis characterized by histiocyte proliferation within lymph nodes and extranodal tissue. Here we report an unusual presentation of RDD in an Italian toddler. Moreover, we reviewed the pediatric case reports published between 2004 and 2014, focusing in particular on medical therapy. Case presentation We report the case of a 14-month-old child who developed a progressive swelling of the right parotid, associated with systemic symptoms and abnormal blood tests. During diagnostic work-up, cervical, intraparotid, and unilateral hilar lymphadenopathies were found. Histopathological and immunohistochemistry studies of a cervical lymph node biopsy established the diagnosis of RDD, with positive PCR for Epstein - Barr virus on the biopsy specimen. Oral steroid therapy was started with progressive reduction in size of all lesions, resolution of systemic symptoms, and normalization of blood tests. Conclusion RDD is generally considered a benign and self-limiting form of histiocytosis, usually associated with favorable prognosis. However, complications are not infrequent and fatal cases were reported even in children. Efforts should be made to establish the best therapeutic strategy for this disease, as no well-defined guidelines exist. Finally, RDD should be included in differential diagnosis of lymphadenopathy and parotid swelling even in very young children. Electronic supplementary material The online version of this article (doi:10.1186/s12887-016-0595-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Francesco di Dio
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Ilaria Mariotti
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Elena Coccolini
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Patrizia Bruzzi
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Barbara Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena & Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy.
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Abstract
Rosai-Dorfman disease (RDD) is a non-malignant pathology of histiocyte proliferation. The classical clinical presentation is with painless cervical lymphadenopathy, but extranodal involvement is frequent, occurring in approximately 40% of cases. The literature was systematically reviewed to identify reported cases of RDD with cardiac involvement. Eighteen cases were identified (3 pediatric and 15 adult). In adult cardiac RDD (cRDD), three patterns of disease were noted: an intra-cardiac mass, epicardial involvement, and pulmonary artery involvement. Reported cases suggest that surgical excision of intra-cardiac masses confers a good prognosis.
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Affiliation(s)
- Kevin O'Gallagher
- Cardiology Department, King's College Hospital NHS Foundation Trust, London, UK
- Address correspondence to: Dr. Kevin O'Gallagher, Cardiology Department, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK. E-mail: k.o'
| | - Luke Dancy
- Cardiology Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Aish Sinha
- Cardiology Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Daniel Sado
- Cardiology Department, King's College Hospital NHS Foundation Trust, London, UK
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Shaikh F, Awan O, Mohiuddin S, Farooqui S, Khan SA, McCartney W. 18F-FDG PET/CT Imaging of Extranodal Rosai-Dorfman Disease with Hepatopancreatic Involvement - A Pictorial and Literature Review. Cureus 2015; 7:e392. [PMID: 26798568 PMCID: PMC4699927 DOI: 10.7759/cureus.392] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 12/02/2015] [Indexed: 11/19/2022] Open
Abstract
We share our experience with serial PET/CT imaging on a patient with extranodal Rosai-Dorfman disease (RDD) with hepatopancreatic involvement. RDD is a benign proliferative disorder of histiocytes mainly involving the lymph nodes. It typically presents with fever and painless cervical lymphadenopathy in young adults and less than half of RDS cases demonstrate extranodal involvement. RDD involvement of the liver and pancreas is extremely rare, and this case highlights the role of PET/CT in its management.
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Affiliation(s)
- Faiq Shaikh
- Imaging Informatics, University of Pittsburgh Medical Center, Pittsburgh, PA. ; Molecular Imaging, Cellsight Technologies, Inc., San Francisco, CA
| | - Omer Awan
- Department of Radiology, Dartmouth Hitchcock Medical Center
| | - Sohaib Mohiuddin
- Department of Radiology, Kansas University Medical Center, Wichita, KS
| | | | - Salman A Khan
- Department of Internal Medicine, University of Missouri-Kansas City
| | - William McCartney
- Department of Radiology, University of North Carolina Hospitals, Chapel Hill, NC
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Abstract
Rosai-Dorfman disease is a rare benign histiocytic disease that infrequently presents in the spine. We report a case of Rosai-Dorfman disease isolated to the epidural thoracic spine in a 26-year-old male. To our knowledge, this is the 15th reported case of isolated spinal disease and only the fourth case of isolated thoracic epidural disease. Given its rarity as well as non-specific symptoms and imaging findings, Rosai-Dorfman disease is often not considered and misdiagnosed on imaging studies. To help improve awareness of Rosai-Dorfman spinal disease, we review the literature and discuss the epidemiology, clinical presentation, imaging features, and treatment considerations for this condition.
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Affiliation(s)
- Benjamin Kozak
- School of Medicine, University of California, San Francisco, CA, USA
| | - Jason Talbott
- Department of Radiology and Biomedical Imaging, San Francisco General Hospital, San Francisco CA, USA; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Alina Uzelac
- Department of Radiology and Biomedical Imaging, San Francisco General Hospital, San Francisco CA, USA
| | - Bhavya Rehani
- Department of Radiology and Biomedical Imaging, San Francisco General Hospital, San Francisco CA, USA; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
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Daruwalla VJ, Parekh K, Tahir H, Collins JD, Carr J. Extranodal Rosai-Dorfman Disease Involving the Left Atrium: Cardiac MRI, CT, and PET Scan Findings. Case Rep Radiol 2015; 2015:753160. [PMID: 26180652 DOI: 10.1155/2015/753160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 05/28/2015] [Accepted: 06/03/2015] [Indexed: 11/19/2022] Open
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.
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Abstract
Immunoglobulin G4-related disease is a recently described systemic clinicopathological entity characterized by immunoglobulin G4-producing plasmacytic infiltration of tissue and frequently by elevated serum immunoglobulin G4 concentration. Manifestations of this disease have been documented in nearly all organs and locations, but coronary artery involvement is not widely recognized. We report the coronary findings of a patient with multi-organ immunoglobulin G4-related disease. Non-electrocardiogram-gated computed tomography of the chest demonstrated nodular and rind-like periarterial soft tissue thickening along the proximal coronary artery segments with improvement following steroid therapy.
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Affiliation(s)
- Yueyang Guo
- School of Medicine, UC San Diego, San Diego, CA, USA
| | - David Ansdell
- Department of Radiology, UC San Diego Health System, San Diego, CA, USA
| | - Sharon Brouha
- Department of Radiology, UC San Diego Health System, San Diego, CA, USA
| | - Andrew Yen
- Department of Radiology, UC San Diego Health System, San Diego, CA, USA
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Lao IW, Dong Y, Wang J. Rosai-Dorfman disease of the pericardium: a case report and review of literature. Int J Clin Exp Pathol 2014; 7:3408-3412. [PMID: 25031768 PMCID: PMC4097210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 04/21/2014] [Indexed: 06/03/2023]
Abstract
Rosai-Dorfman disease (RDD) is an uncommon histiocytic disease of unknown etiology. It typically presents as massive lymphadenopathy with a predilection for the cervical lymph nodes of children and young adults. However, extranodal involvement is not uncommon and may cause confusion with other neoplasms or reactive disease. We describe here a unique case of extranodal RDD manifesting as a pericardial mass in a 69-year-old man. The lesion was detected by computed tomography during a periodic examination of the chest. Subsequently positron emission tomography scan showed mild increase of flurodeoxyglucose uptake. Clinically, it was supposed to be a mesothelioma. Histological examination showed the typical features of RDD confirmed by the staining of S100 protein, which highlighted the emperipolesis of the characteristic histiocytes. To the best of our knowledge, pericardial RDD represents an extremely rare condition and should be included in the differential diagnosis of pericardial neoplasms.
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Affiliation(s)
- I-Weng Lao
- Department of Pathology, Shanghai Cancer Center, Shanghai Medical College, Fudan UniversityShanghai, China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai, China
| | - Yun Dong
- Department of Pathology, Wuxi Hospital of Traditional Chinese MedicineWuxi, China
| | - Jian Wang
- Department of Pathology, Shanghai Cancer Center, Shanghai Medical College, Fudan UniversityShanghai, China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai, China
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Mallick S, Ghosh R, Iyer VK, Jain D, Mathur SR. Cytomorphological and morphometric analysis of 22 cases of Rosai-Dorfman disease: a large series from a tertiary care centre. Acta Cytol 2013; 57:625-32. [PMID: 24192148 DOI: 10.1159/000354947] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 07/23/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Rosai-Dorfman disease (RDD) is a rare benign idiopathic histiocytic proliferation. Most commonly reported cases are lymph nodal. Only 30-40% of cases occur in extranodal sites. Although the morphological features of RDD are well documented, there is limited information about the morphometric variations in the histiocytes of this entity. METHOD Twenty-two cases of RDD diagnosed on fine-needle aspiration cytology (FNAC) were retrieved from the archives. Both Papanicolaou- and May-Grünwald-Giemsa-stained slides were available for evaluation in all cases. Nuclear area, diameter and histiocyte size were measured taking reactive histiocytes as controls. RESULTS Among the 22 patients (male/female ratio 3:2; age range 5-55 years, mean 26 years), 3 cases were extranodal and 19 cases were nodal. The nodal sites included cervical, axillary, inguinal and submandibular lymph nodes. The extranodal sites were the retroperitoneum, mediastinum and skin. The most common clinical presentation was enlarged lymph nodes. Cytological features included numerous large benign histiocytes with emperipolesis. All the morphometric parameters were significantly (p < 0.01) higher in RDD histiocytes than in histiocytes in the reactive lymph node. CONCLUSIONS In view of the rarity of the disease and the variable clinical presentation in RDD, accurate diagnosis is necessary. This is the first study to document the morphometric parameters of RDD histiocytes and their comparison with histiocytes in the reactive lymph node.
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Affiliation(s)
- Saumyaranjan Mallick
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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