乳腺Rosai-Dorfman病1例并文献复习  

Rosai-Doffman disease of the breast:one case report and literature review

作　　者：唐桂莹 仇玮[1] Tang Guiying;Qiu Wei(Jiangning hospital of Nanjing,Nanjing,Jiangsu,211100,China)

机构地区：[1]南京市江宁医院,江苏南京211100

出　　处：《齐齐哈尔医学院学报》2022年第9期851-854,共4页Journal of Qiqihar Medical University

摘　　要：目的报道1例发生于乳腺部位的Rosai-Dorfman病(RDD),探讨RDD的临床病理学特征、鉴别诊断、治疗及预后等。方法采用HE染色和免疫组织化学检测的方法,显微镜下观察病变的组织病理学形态,结合临床相关资料,复习相关中外文献。结果RDD光镜下表现为深染区与淡染区相间交替性分布的特点,深染区由大量增生的淋巴细胞及散在或成片浸润的浆细胞构成,局部区域可见淋巴滤泡形成;淡染区由大片状分布的大的淡染的组织细胞样细胞构成,并可见特征性的“伸入”现象,即胞浆内吞噬完整的淋巴细胞、浆细胞现象。免疫组织化学检测显示大的组织细胞样细胞弥漫强阳性表达S-100及CD68,但CD1a、CKpan阴性。手术切除病变,术后随访36个月,无复发、无转移,恢复状态良好。结论RDD多见于淋巴结内,发生于结外者少见,发生于乳腺更为罕见,确诊需要通过手术切除病变后行常规组织病理学检查及免疫组织化学检测。乳腺RDD需要与慢性炎症性病变、炎性假瘤、乳腺组织细胞样癌、朗格汉斯组织细胞增生症(LCH)、IgG4相关性疾病(IgG4-RD)等鉴别。Objective We report a case of Rosai-Dorfman disease(RDD)located on the breast,and explore the clinical-pathological features,differential diagnosis,treatment,and prognosis.Methods Hematoxylin-eosin staining and immunohistochemical staining methods were used in the study.The histopathological morphology of the lesions was observed under light microscope,meanwhile,accompanied with related clinical information we reviewed the relevant Chinese and foreign literature.Results Microscopically,RDD characterized by the alternating distribution of dark and light dyed areas.The dark staining area was composed of a large number of proliferating lymphocytes and scattered or infiltrated plasma cells,lymphatic follicles are seen locally.Light staining area was composed of the large and histiocytic-like cells distributing in large sheets accompanied with the characteristic phenomenon of emperipolesis that shows histiocytes phagocytosed lymphocytes and plasma cells.Immunohistochemical staining demonstrated that large and histiocytic-like cells were strongly positive for S-100 and CD68,whereas negative for CD1 a and CKpan.The patient with RDD showed a good prognosis after surgical excision and following up for 36 months without recurrence and metastasis.Conclusions RDD commonly occurs in the lymph nodes,rarely occurs in the extranodal sites,and even more rarely occurs in the breast.The diagnosis of RDD acquires histopathological observation and immunohistochemistry after surgical excision of the lesions.The differential diagnosis of extranodal RDD of the breast includes chronic inflammatory disease,inflammatory pseudotumor,histiocytoid breast carcinoma,langerhans cell histiocytosis(LCH),and IgG4-related disease(IgG4-RD).

关 键 词：乳腺 ROSAI-DORFMAN病 临床病理学特征 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤]