Abstract
BackgroundRosai–Dorfman–Destombes (RDD) is also known as sinus histiocytosis with massive lymphadenopathy (SHML). It is a benign proliferative disorder of histiocytes, affecting lymph nodes, rarely with extra-nodal involvement. Rapid on-site evaluation (ROSE) with fine-needle aspiration cytology (FNAC) can be utilized as a minimally invasive investigation to avoid unnecessary surgery of this self-limiting disease.Case presentationA 65-year-old female presented with complaints of bilateral cervical lymphadenopathy since 1 year. Rapid on-site stain with FNAC from bilateral cervical lymph nodes revealed features of Rosai–Dorfman–Destombes (RDD) disease.ConclusionFNAC with rapid on-site evaluation can provide a simple and cost-effective method for looking at the unique cytological features of the disease and act as a first-line investigation.
Highlights
Rosai–Dorfman–Destombes (RDD) is known as sinus histiocytosis with massive lymphadenopathy (SHML)
Rapid on-site evaluation (ROSE) with fine-needle aspiration cytology (FNAC) is a cost-effective, rapid method that can be used for cytological diagnosis of RDD [4]
Cytology can virtually obviate the need for biopsy in most cases, due to its classic morphological resemblance to histopathological features
Summary
The cytological features of RDD are so distinctive that they can be diagnosed by FNAC. Children’s and young adults, M > F, painless lymphadenopathy, extranodal presentation seen. Localized or multiple lesions with disseminated disease. Nodal involvement may be sole manifestation, bone lesion may be seen. Histiocytes with vesicular nucleus S100, CD68 positive, CD1a negative and abundant clear cytoplasm, with fine vacuoles and lymphocytes, reactive background of lymphocytes, plasma cells, neutrophils. Neutrophils, histocytes may or may Histiocytes negative for S100 not be present, Polymorphic infiltrate with eosino- CD1a positive phils and histiocytes with cleaved nucleus. Polymorphic population with small lymphocytes, eosinophils, plasma cells, and RS cells. Lymphoid population with metastatic tumor cells resemblance to primary organ morphology. Depends of cell of origin RS cell positive for CD15 and CD30 Depends on organ of origin have a high degree of suspicion for RDD in patients with massive bilateral lymphadenopathy
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