Extranodal Rosai-Dorfman Disease: Clinicopathologic Series of 10 Patients With Radiologic Correlation and Review of the Literature

Am J Clin Pathol. 2016 Feb;145(2):211-21. doi: 10.1093/ajcp/aqv029. Epub 2016 Jan 23.

Abstract

Objectives: To describe the radiologic and clinicopathologic features of extranodal Rosai-Dorfman disease (RDD) in our patient population.

Methods: Via a data mining engine, we evaluated 13 cases of extranodal RDD in 10 patients treated at our institution from 2000 to 2014.

Results: There was a marked female predominance (90%) in our series. The most common clinical presentation was a palpable, painless mass, which often simulated a neoplasm. Only two cases occurred in children. Multicentric and recurrent disease were uncommon. Histologically, all cases showed large histiocytes with emperipolesis in a mixed inflammatory background, with areas of dense, storiform collagen fibrosis. Positive S-100 and CD68 with negative CD1a in histiocytes are characteristic.

Conclusions: Extranodal RDD is rare and its manifestations varied. It may constitute a clinical and pathologic diagnostic challenge. Clinical suspicion and recognition of its histologic features are necessary for correct diagnosis and avoiding unnecessary treatment. Resection is curative in most cases.

Keywords: Bone; Breast; Gastrointestinal; Hematopathology; Soft tissue.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, CD / metabolism*
  • Antigens, Differentiation, Myelomonocytic / metabolism*
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Emperipolesis
  • Female
  • Fibrosis / diagnostic imaging*
  • Fibrosis / metabolism
  • Histiocytes / pathology*
  • Histiocytosis, Sinus / diagnostic imaging*
  • Histiocytosis, Sinus / metabolism
  • Humans
  • Lymph Nodes / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • S100 Proteins / metabolism*

Substances

  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • CD68 antigen, human
  • S100 Proteins