Rane Sharada R, Parkhi Mayur, Vishwasrao Sharvari, Nakate Leena
Department of Pathology, Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospital, Pune, Maharashtra, India.
Indian J Pathol Microbiol. 2019 Apr-Jun;62(2):319-322. doi: 10.4103/IJPM.IJPM_409_18.
Emperipolesis is the hallmark finding for Rosai-Dorfman disease. Till now many studies in literatures have shown emperipolesis as a finding in other benign as well as malignant conditions. Very few cases of malignant lymphoma have this phenomenon. Herewith, we put forward a rare case of lymphoma with clinical presentation showing involvement of spleen, liver, lymph nodes as well as lleo-cecal region. Light microscopy revealed large to medium sized lymphoid cells with intervening plenty of histiocytes showing evidence of emperipolesis that mimics Rosai Dorfmann disease. Due to atypical clinical presentations we thought of lymphoma as a differential diagnosis. Further immunohistochemistry was performed using histiocytic as well as lymphoid markers. To our surprise, it turns out to be Non Hodgkin Lymphoma with extensive emperipolesis which is extremely rare in thorough literature search. This case is presented due to its unique clinical as well as histological presentations.
嗜组织细胞现象是罗萨伊-多夫曼病的标志性表现。到目前为止,文献中的许多研究表明嗜组织细胞现象在其他良性和恶性疾病中也有发现。恶性淋巴瘤很少有这种现象。在此,我们提出一例罕见的淋巴瘤病例,其临床表现显示脾脏、肝脏、淋巴结以及回盲部均受累。光镜检查显示大到中等大小的淋巴细胞,其间有大量组织细胞,呈现嗜组织细胞现象,类似罗萨伊-多夫曼病。由于临床表现不典型,我们将淋巴瘤作为鉴别诊断考虑。进一步使用组织细胞和淋巴细胞标志物进行免疫组化检查。令我们惊讶的是,结果是伴有广泛嗜组织细胞现象的非霍奇金淋巴瘤,在全面的文献检索中极为罕见。由于其独特的临床和组织学表现,特此报告该病例。