Rosai-Dorfman disease involving gallbladder and liver-Report of a case

Int J Surg Case Rep. 2015:12:140-2. doi: 10.1016/j.ijscr.2015.06.001. Epub 2015 Jun 3.

Abstract

Introduction: Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare histiocytic disorder of unclear etiology. Lymphadenopathy commonly affects the lymph nodes of the neck and the head, but extranodal involvement has been observed too.

Presentation of case: We describe an unusual case of RDD with involvement of the gallbladder, liver and cystic lymph node, clinically manifested as an exacerbated cholecystitis. The patient underwent a cholecystectomy with atypical liver resection because the finding was macroscopically suspected of gallbladder cancer. The diagnosis of RDD was confirmed by immunohistochemical study.

Discussion: Histological features of RDD include histiocytic proliferation, emperipolesis and positive immunostaining for S-100 protein and typically negative for CD1a. Gastrointestinal localization of RDD, especially in the liver and pancreas, is extremely rare. Typically, the liver is affected as a part of systematic spread of RDD. We have not found reports for involvement of the gallbladder.

Conclusion: The presented case is valuable due to its rarity and difficulty in differential diagnosis.

Keywords: Extranodal disease; Gallbladder; Liver; Rosai–Dorfman disease; Sinus histiocytosis.