Jing Xin, McHugh Jonathan B, Pu Robert T
Department of Pathology, University of Michigan Health System, Ann Arbor, Michigan 48109, USA.
Diagn Cytopathol. 2008 Jul;36(7):516-8. doi: 10.1002/dc.20838.
Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) is a rare, benign self-limiting condition of unknown etiology. Less than a quarter of cases have only extranodal involvement and a few cases of skeletal involvement of Rosai-Dorfman disease without associated lymphadenopathy have been reported in the literature. We herein report cytohistologic findings in a case of sole skeletal Rosai-Dorfman disease in a 51-year-old woman who presented with an expansile, heterogeneous lesion at T11 with cord compression and edema. A CT-guided fine-needle aspiration of T-11 lesion was performed and the sample was processed by ThinPrep technique. The ThinPrep smear showed characteristic features of Rosai-Dorfman disease including hypercellularity with moderate number of histiocytes in a background of lymphocytes, plasma cells, and neutrophils. The histiocytes possessed abundant, pale and vacuolated cytoplasm, rounded nuclei with smooth nuclear membranes, fine chromatin, and distinct nucleoli. The histiocytes showed emperipolesis of lymphocytes and neutrophils. The diagnosis was confirmed by concurrent biopsy with immunhistochemical study. Our case highlighted the role of fine-needle aspiration with ThinPrep technique in the diagnosis of Rosai-Dorfman disease.
伴巨大淋巴结病的窦组织细胞增生症(罗萨伊-多夫曼病)是一种病因不明的罕见良性自限性疾病。不到四分之一的病例仅有结外受累,文献中报道过几例无相关淋巴结病的罗萨伊-多夫曼病骨骼受累病例。我们在此报告一名51岁女性单纯骨骼型罗萨伊-多夫曼病的细胞组织学表现,该患者T11处出现一个膨胀性、异质性病变,伴有脊髓受压和水肿。对T11病变进行了CT引导下细针穿刺,并采用ThinPrep技术对样本进行处理。ThinPrep涂片显示了罗萨伊-多夫曼病的特征性表现,包括细胞增多,在淋巴细胞、浆细胞和中性粒细胞背景中有中等数量的组织细胞。组织细胞具有丰富、淡染且有空泡的细胞质,圆形核,核膜光滑,染色质细腻,核仁明显。组织细胞显示有淋巴细胞和中性粒细胞的入胞现象。通过同步活检及免疫组织化学研究确诊。我们的病例突出了ThinPrep技术细针穿刺在罗萨伊-多夫曼病诊断中的作用。