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February 26, 2026International Medical Case Reports Journal0 citationsOpen Access

Fine-Needle Aspiration as a Key Diagnostic Tool in Pediatric Rosai-Dorfman Disease: A Case Report of a 12-Year-Old Male

CPCharles PositeMMMahad MohamedENEluzai Ndiwelubula

Key Result

Fine Needle Aspiration Cytology diagnosed Rosai-Dorfman Disease in a 12-year-old male by identifying emperipolesis, facilitating rapid diagnosis in a resource-limited setting.

Key Points

  • To illustrate the use of Fine Needle Aspiration Cytology (FNAC) for diagnosing Rosai-Dorfman Disease in a pediatric patient.
  • Case report of a 12-year-old male with cervical lymphadenopathy
  • Diagnosis established through Fine Needle Aspiration Cytology
  • Cytological smears examined for emperipolesis
  • FNAC revealed abundant histiocytes with emperipolesis confirming RDD diagnosis
  • The patient was initially diagnosed without systemic symptoms
  • Recommendation for follow-up was made but the patient was lost to follow-up

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
12-year-old male from Uganda with a one-month history of progressive, asymptomatic, bilateral cervical lymphadenopathy.
I
Intervention
Fine Needle Aspiration Cytology (FNAC)
O
Outcome
Diagnosis of Rosai-Dorfman Disease via identification of emperipolesis

High-quality FNAC can reliably establish the diagnosis of Rosai-Dorfman Disease by identifying emperipolesis in resource-limited settings where advanced diagnostic tools are scarce.

Limitations

  • Single patient case report limits generalizability.
  • Lack of confirmatory excisional biopsy and immunohistochemical or molecular analysis.
  • Patient lost to follow-up preventing further evaluation and long-term monitoring.
  • Lack of confirmatory biopsy and molecular data

Abstract

Background: Rosai-Dorfman Disease (RDD) is a rare, benign, non-Langerhans cell histiocytosis characterized primarily by massive, painless cervical lymphadenopathy. Its low prevalence (~ 1:200,000) and clinical similarity to endemic conditions like tuberculosis and lymphoma make the diagnosis challenging, particularly in resource-limited settings. Definitive diagnosis hinges on identifying S100-positive histiocytes exhibiting the pathognomonic feature of emperipolesis. Case Presentation: A previously healthy 12-year-old male from Uganda presented with a one-month history of progressive, asymptomatic, bilateral cervical lymphadenopathy. Systemic symptoms were absent. A provisional diagnosis of RDD was established rapidly via Fine Needle Aspiration Cytology (FNAC). Cytological smears showed abundant histiocytes demonstrating clear emperipolesis, confirming the classic cytological diagnosis. Despite the recommendation for a confirmatory excisional biopsy and further subtyping, the patient was lost to follow-up. Conclusion: This case demonstrates that high-quality FNAC can reliably establish the diagnosis of RDD in environments where advanced diagnostic tools are scarce, but also underscores the critical need to strengthen patient follow-up systems to ensure complete evaluation and long-term monitoring of rare histiocytic disorders. Keywords: Rosai-Dorfman Disease, Fine Needle Aspiration Cytology, Emperipolesis, Cervical Lymphadenopathy, Uganda

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Cite This Study

Posite et al. (2026) conducted a case report in Pediatric Rosai-Dorfman Disease (n=1). Fine Needle Aspiration Cytology (FNAC) was evaluated on Diagnosis of Rosai-Dorfman Disease via cytological identification of emperipolesis on FNAC smears. Fine Needle Aspiration Cytology diagnosed Rosai-Dorfman Disease in a 12-year-old male by identifying emperipolesis, facilitating rapid diagnosis in a resource-limited setting.

synapsesocial.com/papers/699fe40c95ddcd3a253e8368https://doi.org/10.2147/imcrj.s588140
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