Case Report

Extranodal Rosai–Dorfman Disease Presenting as a Mediastinal Mass with Pulmonary Artery Invasion

Table 1

Clinicopathologic features and treatment of RDD involving the pulmonary artery.

ReferenceClinical featuresPathologic featuresTreatmentOutcome

Rehman et al. [13]Syncope with central pulmonary artery filling defect in a 61-year-old womanGrossly: tan, well-circumscribed mass within pulmonary trunkN/ADeceased during attempt at ultrasound-guided intravascular biopsy
Morsolini et al. [14]Dry cough with FDG-avid mass infiltrating right pulmonary artery in a 62-year-old manGrossly: white-yellow mass of solid, fleshy tissue.
Microscopically: large, histiocyte-like cells with emperipolesis in background of mature plasma cells, small lymphocytes, and foamy histiocytes
Pulmonary artery endarterectomyStable and disease-free at 9 months
Walters et al. [15]Progressive dyspnea and lower extremity edema with FDG-avid masses nearly completely obstructing her main pulmonary artery, right pulmonary artery and left pulmonary artery in a 22-year-old womanGross: Tan-white, solid, finely granular specimen.
Microscopically: emperipolesis (in 5–10% of histiocytes) and histiocytic proliferation among an inflammatory infiltrate of plasma cells and lymphocytes set in a fibrous stroma
Debulking operation on cardiopulmonary bypassNo disease recurrence at 5 months from operation
Prendes et al. [16]Progressive dyspnea on exertion with cor pulmonale and bilateral pulmonary artery narrowing due to a mediastinal mass in a 42-year-old womanMicroscopic: Two inconclusive biopsies revealing lymph and fibroadipose tissue, respectively, prior to successful biopsy with pathognomonic features of RDDMedian sternotomy with full cardiopulmonary bypass for resection and reconstruction of the great vessels with multiple grafts placed in the aorta and pulmonary arteryNormalization of right ventricular size with improved function and clinically stable without symptoms or recurrence at 12 months from operation