Kasper Hans-Udo, Hegenbarth Veit, Buhtz Peter
Institute of Pathology and CMMC, University of Cologne, Germany.
Pathol Int. 2004 Feb;54(2):101-4. doi: 10.1111/j.1440-1827.2004.01597.x.
Rhinoscleroma is an uncommon chronic, destructive infection of the respiratory mucosa caused by Klebsiella rhinoscleromatis. This coccobacillus can be found in the typical histiocytes, the Mikulicz cells. Extranasal and nodal involvement in this disease is rare, but documented. Rosai-Dorfman disease or sinus histiocytosis with massive lymphadenopathy is also a rare, non-hereditary disorder. Bilateral cervical lymphadenopathy with emperipolesis, as the main histological characteristic, is the most common presentation. It can also occur extranodally. We report a case of rhinoscleroma occurring in a 62-year-old woman since 1984, who developed parotid gland and lymph node involvement. The changes in the nasal mucosa and the parotid gland showed chronic inflammation with Mikulicz cells. In the lymph nodes, features characteristic of Rosai-Dorfman disease were seen. Taking into consideration the literature dealing with both of these diseases, we discuss that Rosai-Dorfman disease could be a special type of lymph node reaction and is not necessarily an entity of its own. Therefore, it should be known as Rosai-Dorfman lymph node reaction. Furthermore, there seems to be an interconnection between Rosai-Dorfman disease and rhinoscleroma.
鼻硬结病是一种由鼻硬结克雷伯菌引起的罕见的、慢性的、侵袭性呼吸道黏膜感染。这种球杆菌可在典型的组织细胞即米库利奇细胞中发现。鼻硬结病累及鼻外和淋巴结的情况罕见，但有文献记载。罗萨伊-多夫曼病或伴巨大淋巴结病的窦性组织细胞增多症也是一种罕见的非遗传性疾病。以嗜组织细胞现象为主要组织学特征的双侧颈部淋巴结病是其最常见的表现形式。该病也可发生于淋巴结外。我们报告一例自1984年起发病的62岁女性鼻硬结病患者，其出现了腮腺和淋巴结受累。鼻黏膜和腮腺的改变显示为伴有米库利奇细胞的慢性炎症。在淋巴结中，可见罗萨伊-多夫曼病的特征。考虑到有关这两种疾病的文献，我们讨论认为罗萨伊-多夫曼病可能是一种特殊类型的淋巴结反应，不一定是一种独立的疾病实体。因此，应将其称为罗萨伊-多夫曼淋巴结反应。此外，罗萨伊-多夫曼病与鼻硬结病之间似乎存在某种联系。
