title: Multicentric extranodal Rosai Dorfman disease--a cytological diagnosis, with histological corroboration.
abstract: BACKGROUND
  Rosai Dorfman disease (RDD) typically presents with massive bilateral cervical lymphadenopathy, a viral-like prodrome, elevated erythrocyte sedimentation rate, and polyclonal hypergammaglobulinemia. Other lymph nodes may be less commonly involved. Extranodal RDD is quite rare, and orbital disease accounts for only 10% of the extranodal sites of involvement. Multicentric disease has also been described, which is usually accompanied by lymphadenopathy either initially or later in the disease course.
  
  
  METHODS
  We report an extremely rare extranodal multicentric disease in a diabetic patient, presenting with bilateral orbital involvement, causing ocular motility restriction, which was diagnosed on aspiration cytology of the orbital mass. This was followed in quick succession by new mass lesions in the lower back and infratemporal fossa. On extensive work-up, no lymphadenopathy was detected. The patient responded well to surgical debulking of the orbital lesions and systemic steroids.
  
  
  CONCLUSIONS
  Fine needle aspiration cytology can be effectively applied for early diagnosis of multicentric extranodal RDD. Surgical debulking in such cases may be supplemented by systemic steroids.
authors.affiliation: Department of Pathology, GB Pant Hospital, New Delhi, India.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Majumdar
authors.forename: Ila
authors.initials: I
authors.lastname: Tyagi
authors.forename: Ravindra K
authors.initials: RK
authors.lastname: Saran
authors.forename: Sushil
authors.initials: S
authors.lastname: Kumar
authors.forename: Ranjana
authors.initials: R
authors.lastname: Gondal
mesh_terms: D001415:Back / Q000473:pathology* / Q000601:surgery; D044963:Biopsy, Fine-Needle / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D015618:Histiocytosis, Sinus / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009915:Orbit / Q000473:pathology* / Q000601:surgery; D009916:Orbital Diseases / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D040521:Subcutaneous Tissue / Q000473:pathology* / Q000601:surgery