Case Study: March 2008


A 12-year-old-boy presents with a mass in the nasal cavity, maxillary sinus and orbit.
The orbit component is biopsied.

Figure 1-H and E low power of mass showing ‘dark’ and ‘light’ areas.
Figure 2-Higher power of ‘dark’ area.
Figure 3-Higher power of ‘light’ area.
Figure 4- CD68 immuno on ‘light’ area
Figure 5-S100 immuno on ‘light’ area

The ‘light’ area cells were negative for CD1a, Melan A and cytokeratins.


1. What are the cells in the ‘light’ areas?

2. What is the predominant cell type in the ‘dark’ areas?

3. What is the diagnosis?

4. Whilst not fully developed in this case, which other histological feature in this entity would you look for?

Click to show answers

1. Histiocytes (monocyte-macrophages).

2. Plasma cells

3. The anatomical location, histological features and immunophenotype all add up to a diagnosis of extranodal, orbital Rosai-Dorfman disease.

4. Emperipolesis.


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