Cold thyroid nodule as the sole manifestation of Rosai-Dorfman disease with mild lymphadenopathy, coexisting with chronic autoimmune thyroiditis

A case of thyroid Rosai-Dorfman disease (RDD) without apparent lymphadenopathy in a 49-year-old woman with underlying euthyroid chronic autoimmune thyroiditis, as indicated by high thyroid autoantibodies titers, is presented. The initial presentation was that of a cold, hypoechogenic nodule of left...

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Bibliographic Details
Published in:Journal of endocrinological investigation 1999-12, Vol.22 (11), p.866-870
Main Authors: TAMOURIDIS, N, DELADETSIMA, J. K, KASTANIAS, I, DELIS, S, BRAMIS, J, ZERVA, C. A, ANAPLIOTOU, M. L. G
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Biopsy, Needle
Chronic Disease
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
Hematologic and hematopoietic diseases
Histiocytes - pathology
Histiocytosis, Sinus - complications
Histiocytosis, Sinus - diagnosis
Histiocytosis, Sinus - pathology
Humans
Lymphatic Diseases - pathology
Medical sciences
Non tumoral diseases
Other diseases. Hematologic involvement in other diseases
Thyroid Nodule - diagnostic imaging
Thyroid Nodule - pathology
Thyroid Nodule - surgery
Thyroidectomy
Thyroiditis, Autoimmune - complications
Thyroiditis, Autoimmune - diagnosis
Thyroiditis, Autoimmune - pathology
Thyroxine - therapeutic use
Ultrasonography
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Summary:A case of thyroid Rosai-Dorfman disease (RDD) without apparent lymphadenopathy in a 49-year-old woman with underlying euthyroid chronic autoimmune thyroiditis, as indicated by high thyroid autoantibodies titers, is presented. The initial presentation was that of a cold, hypoechogenic nodule of left thyroid lobe which increased in size during the two years of follow up, together with new ultrasonographic findings of the right lobe. No biochemical abnormalities were found apart from mild hypercalcemia. A near total thyroidectomy was performed. Histologically, the left lobe nodule as well as the right lobe lesions consisted of typical RDD cellular population, with the pathognomonic phenomenon of emperipolesis. Infiltration to the periphery of the gland was observed and three adjacent lymph nodes were also involved. The uninvolved thyroid parenchyma showed changes compatible with chronic autoimmune thyroiditis. No other localizations or systemic manifestations of RDD were revealed. Normocalcemia was restored promptly and the patient remains free of clinically overt disease one year post-operatively.
ISSN:0391-4097
1720-8386
DOI:10.1007/BF03343661