Intracranial ROSAI-DORFMAN Disease
A 33-years-old man was referred to our hospital on December 2010, his complaint was unconsciousness. According to his past medical history, he was suffering from frontal headache, ataxia and dizziness with no sensory or motor defect since August 2010. He was married and worked in Butcher shop since many years ago. His economic and health condition was not suitable. He had low literacy. His familial history was non-contributory. At initial work up, brain CT scan and MRI showed infiltrating mass adjacent to lateral ventricle with effacement of anatomical sign of the left parietal region. Left frontal horn was collapsed and left temporal horn was dilated []. There was subfalcine hernia to the right side []. No definite lesion was found at the dura. Laboratory tests were unremarkable.\nHe was candidate for surgical operation with an initial diagnosis of glioma versus lymphoma. The lesion was excised and was sent to our laboratory for pathologic examination. It was gray- white in color and rubbery in consistency.\nMicroscopically, it consisted of infiltration of abundant lymphoplasma cells, neutrophils and some histiocytes scattered in fibrotic background [].\nThe infiltration of lymphoplasma cells and neutrophils were so intense that obscured background histiocytes. Some histiocytes showed sheet like arrangement without granulomatous formation. The cytoplasm of the histiocytes was pale and eosinophilic, and sometimes foamy. The vesiculated nuclei of the histiocytes were not folded. Emperipolesis (lymphocytophagocytosis) of histiocytic cells made the diagnosis of Rosai-Dorfman disease [].\nImmunohistochemical staining was performed to rule out the meningioma and confirm the diagnosis. It was noticeable that plasma cells were immunoreactive for EMA []. Suspected cells were negative for epithelial membrane antigen (EMA) and positive for S100 [].