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Rosai–Dorfman disease presenting as a solitary mediastinal mass
Author(s) -
Hida Akira I.,
Yagi Shinichi,
Obase Yasushi,
Nishimura Hirotake,
Akiyama Takashi,
Irei Isao,
Hamazaki Shuji,
Oka Mikio,
Sadahira Yoshito
Publication year - 2009
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2009.02362.x
Subject(s) - medicine , pathology , rosai–dorfman disease , histiocyte , malignancy , lesion , emperipolesis , cd68 , biopsy , lymphoma , mediastinum , mediastinal lymph node , immunohistochemistry , differential diagnosis , radiology , cancer , metastasis
Rosai–Dorfman disease (RDD) involving an extranodal site is a diagnostic challenge. Reported herein is the case of a 67‐year‐old man who presented with a solitary superior mediastinal mass. The lesion was clinically suspected of malignancy including lymphoma because of its high uptake during a 67 Ga‐scintigram and 18 F‐fluorodeoxyglucose–positron emission tomography. There was no evidence of spread of the disease. Histology of thoracoscopic biopsy specimens indicated granulomatous lesion with infiltration of lymphocytes, plasma cells, and histiocytes with lymphocytes engulfed in their cytoplasm. The lesion did not contain lymph node or thymic elements. On immunohistochemistry the histiocytes were positive for S‐100 protein, CD68, and CD163 but were negative for CD1a. These findings suggested a diagnosis of RDD. Despite lack of intervention, the lesion remained almost the same size for 3 years. To the best of the authors' knowledge this is the first case of RDD presenting as a solitary mediastinal mass.