Rosai-Dorfman Disease Presenting as a Breast Mass and Enlarged Axillary Lymph Node Mimicking Malignancy: A Case Report and Review of the Literature

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.

Rosai-Dorfman Disease of the Breast

“…Patients typically present with painless palpable breast masses, although several cases have been discovered in asymptomatic women on screening mammogram [4-5]. Rosai-Dorfman lesions in the breast commonly have an appearance that is indistinguishable from breast carcinoma on mammogram and ultrasound [6-7].…”

“…Rosai-Dorfman lesions in the breast commonly have an appearance that is indistinguishable from breast carcinoma on mammogram and ultrasound [6-7]. For this reason, most patients have historically undergone excisional biopsy [4]. However, as in this case, a pathologic diagnosis can be made with core biopsy.…”

Extranodal manifestation of Rosai-Dorfman disease in the breast tissue

“…RDD can have a high rate of recurrence which could potentially lead to repeated biopsies and excisions in the breast tissue [14]. Notably, incidental discovery of RDD in the breast parenchyma necessitates establishing the full extent of disease elsewhere in the body with full body CT and abdominal ultrasound [15]. Positron emission tomography/CT can also be useful for characterization because areas of involvement by RDD can possess fludeoxyglucose avidity [16].…”

Enfermedad De Rosai-Dorfman Mamario

“…Se han descrito casos en que el uso de PAAF no logró diagnóstico definitivo e incluso indujo a error, por lo que finalmente fue necesaria una biopsia excisional 10,11 . La enfermedad de Rosai Dorfman se define por sus hallazgos histopatológicos: ganglios linfáticos infiltrados por abundantes histiocitos, que pueden mostrar atipia moderada con pleomorfismo nuclear y nucléolo prominente.…”