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AJNR - American Journal of Neuroradiology

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Rosai-Dorfman Disease Presenting with Isolated Bilateral Orbital Masses: Report of Two Cases

Edwin Wang^a, Yoshimi Anzai^a, August Paulino^a and Jeffery Wong^a

^a From the Department of Radiology (E.W., Y.A., J.W.) and the Department of Pathology (A.P.), University of Michigan Medical Center, Ann Arbor, Michigan.

View larger version (110K): [in a new window]   FIG 1. Case 1, extranodal orbital involvement in Rosai-Dorfman disease. Axial (A) image from contrast-enhanced CT scan demonstrates abnormal, heterogeneously enhancing orbital soft tissue, producing marked bilateral exophthalmos and bowing of the right optic nerve (arrows). Coronal (B) image from the same examination reveals involvement of the ethmoid and maxillary sinuses, and the nasal cavity, with prominent orbital floor hyperostosis, and demineralization of the turbinates

View larger version (142K): [in a new window]   FIG 2. Case 1, histologic sample from left orbital mass. High-power image (hematoxylin and eosin stain) from excisional biopsy demonstrates abundant histiocytes with lymphocytic infiltrate. A few histiocytes exhibit lymphophagocytosis (arrows), characteristic of Rosai-Dorfman disease

View larger version (119K): [in a new window]   FIG 3. Case 2, extranodal cervical nodal involvement in Rosai-Dorfman disease. Axial images (A and B) from contrast-enhanced demonstrate prominent cervical lymphadenopathy bilaterally, involving multiple nodal groups, including submandibular and posterior cervical nodes.