Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4285
Peer-review started: January 15, 2021
First decision: February 11, 2021
Revised: February 22, 2021
Accepted: March 29, 2021
Article in press: March 29, 2021
Published online: June 16, 2021
Rosai-Dorfman disease (RDD) is a rare benign proliferative disease whose etiology is not clear and may be related to infection or unexplained immune dysfunction. The authors present a case of RDD with lung involvement in a 10-year-old patient.
A 10-year-old girl found that her left cervical lymph nodes were enlarged for more than 7 mo, and the largest range was about 6.5 cm × 5.9 cm × 8.1 cm. Cervical magnetic resonance imaging showed multiple masses in the left neck, with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. A malignant tumor, with a high possibility of lymph node metastasis, was initially considered. At the same time, lung computed tomography showed multiple nodules of different sizes scattered on both sides of the lung, with uniform internal density. Thus, a possible metastatic tumor was considered. Finally, RDD was diagnosed by pathology and immunohistochemistry. According to the antibiogram, clindamycin was administered for 2 wk, and prednisone acetate was administered for 7 wk. Nine months later, the ulcer in the left neck was better than before, but the imaging showed that the lesion was not controlled.
The diagnosis of RDD cannot be made by a single tool and its treatment is a long-term exploratory process. Follow-up is necessary.
Core Tip: In this paper we report a 10-year-old girl characterized by enlarged left cervical lymph nodes. Imaging suggested a malignant tumor with pulmonary metastasis, and Rosai-Dorfman disease (RDD) was finally diagnosed by pathological and immunohistochemical methods. This case suggests that attention should be paid to RDD in the differential diagnosis of cervical masses. Second, the diagnosis of RDD should not rely solely on imaging examination, and different diagnostic methods should be used. Moreover, although rare, there is a situation that RDD involves the lungs. Finally, the treatment of RDD needs to be constantly explored and the treatment plan should be adjusted according to the follow-up results.