Rosai-Dorfman disease of the breast mimicking cancer

Department of Gynecology, Federal University of Piauí, Teresina, Piauí, Brazil.
Pathology - Research and Practice (Impact Factor: 1.4). 02/2007; 203(10):741-4. DOI: 10.1016/j.prp.2007.05.012
Source: PubMed


Rosai-Dorfman disease or sinus histiocytosis with massive lymphadenopathy is a rare proliferative histiocytic disorder of the lymph nodes. Extranodal involvement occurs in a considerable number of cases; however, involvement of the breast is very rare, and it is even rarer for the lesion to be localized in the breast alone without affecting any other sites. This report describes the case of a 50-year-old Brazilian woman with a lump confined to her left breast that had clinical and radiological characteristics indistinguishable from cancer. The proliferation of histiocytes, displaying lymphophagocytosis and an S-100 protein immunophenotype on a core biopsy of the lesion, led to a diagnosis of Rosai-Dorfman disease and permitted conservative therapy. Recognition of this rare condition, when occurring at an unexpected site such as the breast, is difficult, and the correct diagnosis is important prior to therapeutic management.

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    ABSTRACT: Rosai-Dorfman disease (RDD), or sinus histiocytosis with massive lymphadenopathy, is a benign, self-limiting disease. In the majority of cases, there is massive and painless lymphadenopathy in any lymph node group but most commonly in the cervical lymph nodes, associated with constitutional symptoms. Extranodal involvement has been reported to occur in almost every organ system, with or without concomitant nodal disease. The breast is a rare site of presentation of this disease. A 35-year-old male presented with a hard, nodular swelling in the lower and outer quadrant of the right breast, with a clinical suspicion of malignancy. A diagnosis of sinus histiocytosis with massive lymphadenopathy, or RDD, was offered based on the presence of numerous lymphocytes, plasma cells, a few neutrophils and large histiocytes showing emperipolesis in fine needle aspiration smears. Mammary RDD is extremely rare in males. The cytologic features are fairly characteristic and should be considered in the differential diagnosis whenever atypical histiocytes and emperipolesis are encountered in fine needle aspiration smears.
    Acta cytologica 01/2010; 54(3):349-52. · 1.56 Impact Factor
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    ABSTRACT: We present a case of Rosai-Dorfman disease misdiagnosed as lymphoma involving the right breast. Initially, the patient was diagnosed as malignant lymphoma, mucosa-associated lymphoid tissue type. After lumpectomy, she did not receive further management. Five months later, she developed a local recurrence in the right breast. She underwent incisional biopsy of the recurrent right breast lesion. Pathology demonstrated Rosai-Dorfman disease. She was prescribed oral prednisolone of 5 mg daily for 4 weeks. However, the lump persisted and did not respond to the therapy. She was treated with lumpectomy of the recurrent right breast lesion at her request for cosmetic reasons and has regular postoperative follow-up for the last 2 years.
    The American Journal of the Medical Sciences 03/2010; 339(3):282-4. DOI:10.1097/MAJ.0b013e3181c29d3f · 1.39 Impact Factor
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    ABSTRACT: Rosai-Dorfman disease (also known as sinus histiocytosis with massive lymphadenopathy) is an uncommon, idiopathic, benign histiocytic lesion. It usually involves the cervical lymph nodes and, less commonly, extranodal sites. Involvement of the breast is rare, with only 17 cases reported in the English literature to date. Here we describe 3 new patients with extranodal Rosai-Dorfman disease in the breast. All 3 patients-aged 45, 53, and 54 years-presented with solid breast lesions that were detected on screening mammography and had no clinical history of Rosai-Dorfman disease or radiographic evidence of extramammary involvement. Initial diagnoses were accomplished by needle core biopsy in the one case and excisional biopsy in the other two. We present the histopathologic findings and follow-up of each patient and conduct a literature review of mammary Rosai-Dorfman disease with emphasis on its differential diagnosis. Because Rosai-Dorfman disease frequently mimics invasive breast carcinoma in its clinical presentation and radiographic appearance-and can mimic other benign or malignant histiocytic lesions microscopically-awareness and appropriate diagnosis of this entity are essential for proper treatment.
    Annals of diagnostic pathology 04/2010; 14(2):81-7. DOI:10.1016/j.anndiagpath.2009.12.001 · 1.12 Impact Factor
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