Rosai-Dorfman disease of the breast: a mimic of breast malignancy

• Published in: Pathology Vol. 32; no. 1; pp. 10 - 15
• Main Authors: Ng, Siok Bian, Tan, Leonard H.C., Tan, Puay Hoon
• Format: Journal Article
• Language: English
• Published: London Elsevier B.V 2000; Informa UK Ltd; Taylor and Francis
• Subjects: Adult; Biological and medical sciences; Biopsy, Needle; Breast; Breast Neoplasms - diagnosis; Diagnosis, Differential; emperipolesis; Female; Gynecology. Andrology. Obstetrics; Hematologic and hematopoietic diseases; Histiocytes - metabolism; Histiocytes - ultrastructure; Histiocytosis, Sinus - diagnosis; Histiocytosis, Sinus - metabolism; Humans; Immunohistochemistry; Mammary gland diseases; Mammography; Medical sciences; Middle Aged; Other diseases. Hematologic involvement in other diseases; Rosai-Dorfman disease; S-100 protein; S100 Proteins - metabolism; sinus histiocytosis with massive lymphadenopathy; Tropical medicine; Tumors; Breast; sinus histiocytosis with massive lymphadenopathy; S-100 protein; emperipolesis; Rosai-Dorfman disease; Human; Immunohistochemistry; Carcinoma; Hemopathy; Malignant tumor; Electron microscopy; Aspiration punction; Differential diagnostic; Case study; Pathology; Mammary gland diseases; Fine needle; Sinus histiocytosis; Adult; Cytopathology; Female; Mammary gland
• ISSN: 0031-3025; 1465-3931
• DOI: 10.1080/003130200104493

Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy (SHML) is primarily a nodal-based, idiopathic, benign proliferative disorder of histiocytes with 43% of these cases also involving extranodal sites. The breast is an unusual site of occurrence of RDD. We report two cases of this exceptional event. The first represents an intramammary nodal Rosai-Dorfman disease, while the second is an extranodal disease with sole involvement of the breast. In both, the possibility of malignancy was raised. Histological examination of the two breast lesions revealed sheets of characteristic large histiocytes displaying emperipolesis, a microscopic hallmark of this disease. Immunohistochemical and ultrastructural studies were also performed; the former showed cytoplasmic staining of histiocytes for S-100 protein, while histiocytes that engulfed lymphocytes and plasma cells were identified on electron microscopy.