Case Study: August 2015

History

A 5 year old male of African origin presents with a right-sided massive axial proptosis with corneal exposure/ulceration. An intraconal and extraconla mass is seen on the scan and he under goes a biopsy.

Questions

1. Describe Fig 1

2. Which cells are seen in Fig 2?

3. Which cells are seen in Fig 3?

4. Name the stain used in Fig 4 and which pathological process is delineated?

5. What is the diagnosis?

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1. Light and dark celular zones with sharp demarcation.

2. Eosinophilic histiocytes with slighly bubbly cytoplasm.

3. Mature plasma cells.

4. S100 staining the histiocytes with negative profile of ingested lymphocytes-this is emperipolesis.

5. Orbital extra-nodal Rosai-Dorfman disease.

References

Tan JJ, Narang S, Purewal B, Langer PD, Blaydon S, Schwarcz RM, McCormick SA, Kim JY, Walrath JD, Burt BO, Shinder R. Extranodal Rosai-Dorfman Disease of the Orbit: Clinical Features of 8 Cases. Ophthal Plast Reconstr Surg. 2015

McClellan SF, Ainbinder DJ. Orbital Rosai-Dorfman disease: a literature review. Orbit. 2013 Oct;32(5):341-6