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An 81-year-old man presented with anemia, fatigue, weight loss, and recurrent urinary tract infections and was found to have diffuse large adenopathy and infiltrating renal masses. Surgical excision of a lymph node and histologic evaluation led to the diagnosis of Rosai-Dorfman disease, a rare histioproliferative condition that classically presents with enlarged cervical lymph nodes bilaterally. It also can involve additional nodal chains and/or have extranodal manifestations. The condition can self-resolve or have periods of remission and reactivation.

Rosai-Dorfman disease in a symptomatic elderly man