Rosai-Dorfman disease of the breast mimicking cancer

Department of Gynecology, Federal University of Piauí, Teresina, Piauí, Brazil.
Pathology - Research and Practice (Impact Factor: 1.56). 02/2007; 203(10):741-4. DOI: 10.1016/j.prp.2007.05.012
Source: PubMed

ABSTRACT 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: Background 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. Case 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. Conclusion 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 Cytol 2010;54:349-352)
    05/2010; 54(3):349-352. DOI:10.1159/000325050
  • Clinical Radiology 12/2011; 67(4):393-5. DOI:10.1016/j.crad.2011.10.012 · 1.66 Impact Factor
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    ABSTRACT: Rosai-Dorfman disease (also called sinus histiocytosis with massive lymphadenopathy) involves lymph nodes or lymph nodes with extranodal sites. We present a unique case of a patient presenting with a breast mass and axillary lymphadenopathy, mimicking malignancy clinically and radiographically. Core needle biopsies of the breast and axillary lymph node showed histologic features concerning the lymphoma. However, excisional biopsy specimen demonstrated characteristic features of Rosai-Dorfman disease. The disease recurred locally 6 months later in the same breast, 1 month later in the contralateral breast, and 11 month later in the subcutaneous tissue of left flank. A review of the literature of Rosai-Dorfman disease involving the breast is also presented.
    The Breast Journal 07/2011; 17(5):516-20. DOI:10.1111/j.1524-4741.2011.01131.x · 1.43 Impact Factor