Fine-needle aspiration cytology of Rosai-Dorfman disease of the breast: A case report

We report the cytologic findings of a case of Rosai-Dorfman disease of the breast in a 52-year-old diabetic woman, initially sampled by fine-needle as piration biopsy (FNA). The patient presented with a 2-week history of a 3 x 2 cm nodule in the mid-upper area of the left breast. A mammogram taken 6 months prior was negative. FNA smears demonstrated lymphocytes, plasma cell s, and large pale cells, with enlarged irregular nuclei, admixed with fragm ents of fibrous tissue and calcific debris. Lymphophagocytosis (emperipoles is) was scarce. Our diagnosis was atypical lymphohistiocytic proliferation. Flow cytometry was negative, but excision was performed. The final diagnos is was Rosai-Dorfman disease (RDD). The differential diagnosis of FNA of br east disease inflammatory lesions with atypical cytology is discussed, with a review of the literature. The early recognition on FNA of the hallmarks of this rare disease should prevent unnecessary radical surgery. (C) 1999 W iley-Liss, Inc.