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Jai Kumar Chaurasia

Jai Kumar Chaurasia

Dr Lal PathLabs, India

Title: Histiocytic disorders: Cytological perspective

Biography

Biography: Jai Kumar Chaurasia

Abstract

Histiocytic disorders encompasses a number of distinctive entities, arising from histiocytic proliferation ranging from benign, self-resolving lesions to malignant, life-threatening histiocyte rich leukemias and sarcomas. Histiocytes are derived from stem cell precursors in bone marrow from macrophages which later undergo differentiation in various organs to form histiocytes, which are part of the mononuclear phagocytic system. Cytology plays a pivotal role in diagnosing histiocytic disorders, leading to early diagnosis with implications regarding prognosis and treatment. Here, we discuss an interesting case of Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy with detailed discussion of differential diagnosis encompassing other histiocytic disorders such as Langerhans cell histiocytosis, hemophagocytic lymphohistiocytosis, xanthogranulomatous lymphohistiocytosis, reactive sinus histiocytosis and histiocyte rich lymphomas and tuberculosis. Rosai-Dorfman disease is a rare non-neoplastic, self-limiting histiocytic proliferative disorder of unknown etiology that usually presents with painless bilateral cervical lymphadenopathy and show distinct cytological features. Retroperitoneal lymph node enlargement due to Rosai-Dorfman disease is unusual and is rarely reported in literature. It is a difficult diagnosis due to disease’s non-specific clinical, hematological and radiological findings, often overlapping with other histiocytic disorders. We here discuss an unusual case of Rosai-Dorfman disease in male patient who presented with diffuse abdominal pain and retroperitoneal lymphadenopathy and diagnosed on fine-needle aspiration cytology. This presentation emphasizes that histiocytic disorders should always be dealt with great care and FNAC can be used as a reliable tool to establish the diagnosis, avoiding unnecessary excisional biopsy, aggressive intervention and overtreatment.