Cytology of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease)

Sinus histiocytosis with massive lymphadenopathy (SHML) isa benign, self-li miting condition of unknown etiology, which generally presents as massive b ilateral cervical lymphadenopathy It is important to distinguish SHML from other causes of histiocytosis because of the different treatment modalities . This study was carried out to assess the utility of fine-needle aspiratio n cytology (FNAC) findings in SHML and to distinguish if from other reactiv e lymphadenopathies. The lymph nodes in 4 patients (3 male and 1 female) presenting with massive bilateral cervical lymphadenopathy were aspirated. All presented with pers istent bilateral cervical lymphadenopathy, polymorphnuclear leukocytosis, a nd raised erythrocyte sedimentation rare (ESR). Smears showed a reactive ly mphoid population consisting of mature lymphocytes, plasma cells, a few pol ymorphs, and many histiocytes showing emperipolesis. Based on the cytologic and clinical findings, a diagnosis of SHML was made. Histopathology confir med the diagnosis in all cases. A conclusive diagnosis of SHML can be based on cytology provided that the c ytologic findings are interpreted in the appropriate ate clinical context. Biopsy can be avoided in these patients. Diagn. Cytopathol. 2000;22: 181-18 5. (C) 2000 Wiley-Liss, Inc.