Otorrinolaringología, Hospital Universitario Doctor Peset, Valencia, Spain.
Otorrinolaringología, Hospital Universitario Doctor Peset, Valencia, Spain
BMJ Case Rep. 2023 Sep 18;16(9):e254152. doi: 10.1136/bcr-2022-254152.
A man in his 40s, with no tobacco or alcohol habit, was referred to the otorhinolaryngology department presenting with a 2-month history of enlarged left cervical lymphadenopathy with no other signs or symptoms. The ear, nose and throat examination showed no abnormalities apart from the described lymphadenopathy. An ultrasound scan suggested these nodes to be part of either an inflammatory or a malignant process. Subsequent positron emission tomography-CT proved those lymph nodes to be metabolically active, as well as others within the thorax. Cervicotomy was performed and the histopathological analysis showed dilated sinuses and histiocytes with emperipolesis. Suspecting Rosai-Dorfman disease (RDD), high-dose steroid therapy was started; but given no improvement was observed, a second cervicotomy was performed, with the histopathological diagnosis of the latter of Hodgkin's lymphoma. The present article aims to emphasise the need to exclude haematological disorders whenever RDD histology is observed, given their possible coexistence, and a worse outcome and clinical and histopathological semblance.
一位 40 多岁的男性，无吸烟和饮酒习惯，因左侧颈部淋巴结肿大就诊，病史为 2 个月，无其他体征或症状。耳鼻喉科检查除描述的淋巴结病外无其他异常。超声扫描提示这些淋巴结为炎症或恶性过程的一部分。随后的正电子发射断层扫描-CT 显示这些淋巴结以及胸部内的其他淋巴结代谢活跃。行颈淋巴结清扫术，组织病理学分析显示窦扩张和伴有吞噬现象的组织细胞。考虑罗塞达-多夫曼病（RDD），开始大剂量类固醇治疗；但观察到无改善，行第二次颈淋巴结清扫术，后者的组织病理学诊断为霍奇金淋巴瘤。本文旨在强调每当观察到 RDD 组织病理学时，无论如何都需要排除血液系统疾病，因为它们可能同时存在，且预后更差，临床和组织病理学表现相似。
