Korean J Pathol.  2012 Oct;46(5):489-493.

Rosai-Dorfman Disease in the Breast with Increased IgG4 Expressing Plasma Cells: A Case Report

• Cha YJ
• Yang WI
• Park SH
• Koo JS

Abstract

Rosai-Dorfman disease (RDD) can present in any anatomic site, but breast involvement is rarely reported. Recently, a relationship between RDD and IgG4-related sclerosing disease has been suggested. Here we report another case of RDD with overlapping features of IgG4-related sclerosing disease occurring in a right breast of a 62-year-old female. On microscopic examination, the mass demonstrated a characteristic zonal pattern of proliferation of large polygonal histiocytes and lymphoplasma cells with stromal fibrosis. Emperipolesis was observed in histiocytes with abundant cytoplasm, which showed immunoreactivity for S-100 protein and CD68; the diagnosis of RDD was made. Sheets of plasma cells in the fibrotic stroma demonstrated positive reactions for IgG and IgG4. The mean count of IgG4-positive plasma cells was 100.2/high power field, and the ratio of IgG4/IgG was 56.7%. Additional findings of stromal fibrosis and obliteration of preexisting breast lobules suggested overlapping features with IgG4-related sclerosing disease.

Keyword

Breast; Histiocytosis; Immunoglobulin G; Histiocytosis, sinus

MeSH Terms

Breast
Cytoplasm
Emperipolesis
Female
Fibrosis
Fluconazole
Histiocytes
Histiocytosis
Histiocytosis, Sinus
Humans
Immunoglobulin G
Middle Aged
Plasma
Plasma Cells
S100 Proteins
Fluconazole
Immunoglobulin G
S100 Proteins