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Open Access Case report

18F-fluoro-deoxyglucose positron emission tomography/computed tomography scan findings in Rosai-Dorfman disease with IgG4-positive plasma cell infiltration mimicking breast malignancy: a case report and literature review

Liping Fu1, Mei Liu2, Zhigang Song2, Baixuan Xu1 and Jiahe Tian1*

Author Affiliations

1 Department of Nuclear Medicine, the Chinese PLA General Hospital and PLA Medical School, Fuxing Road 28, Beijing, 100853, China

2 Department of Pathology, the Chinese PLA General Hospital and PLA Medical School, Fuxing Road 28, Beijing, 100853, China

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Journal of Medical Case Reports 2012, 6:411  doi:10.1186/1752-1947-6-411

Published: 30 November 2012

Abstract

Introduction

Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy, is a rare benign disorder characterized histologically by lymphatic sinus dilatation due to histiocyte proliferation. Rosai-Dorfman disease accompanied by IgG4+ plasma cell infiltration is an even rarer situation. To the best of our knowledge, no imaging report of fluoro-deoxyglucose positron emission tomography/computed tomography findings of Rosai-Dorfman disease with IgG4+ plasma cell infiltration has been published, although a series of pathological research has focused on this phenomenon.

Case presentation

We reviewed the 18F-fluoro-deoxyglucose positron emission tomography/computed tomography scan of a 78-year-old Chinese woman with a solid mass that was found in her right breast during a health checkup. 18F-fluoro-deoxyglucose positron emission tomography/computed tomography showed a hypermetabolic nodule in her right breast and slightly heterogeneous increased fluoro-deoxyglucose uptake of the pulmonary nodules, which were histologically proven to be mammary Rosai-Dorfman disease with IgG4+ plasma cell infiltration and pulmonary amyloidosis, respectively. A literature review was performed to gather information on this rare disease process.

Conclusions

Although distinguishing benign lymphoplasmacytic proliferation from malignancy may be difficult with 18F-fluoro-deoxyglucose positron emission tomography/computed tomography in light of the pattern and intensity of fluoro-deoxyglucose uptake, our case highlights that whole-body positron emission tomography/computed tomography imaging not only can display the extent of the disease to help complete staging but also can provide functional information about disease activity to guide biopsy.

Keywords:
Rosai-Dorfman disease; IgG4-related sclerosing disease; Amyloidosis; Position emission tomography