A case of thyroid Rosai-Dorfman disease (RDD) without apparent
lymphadenopathy in a 49-year-old woman with underlying euthyroid chronic
autoimmune thyroiditis, as indicated by high thyroid autoantibodies
titers, is presented. The initial presentation was that of a cold,
hypoechogenic nodule of left thyroid lobe which increased in size during
the two years of follow up, together with new ultrasonographic findings
of the right lobe. No biochemical abnormalities were found apart from
mild hypercalcemia. A near total thyroidectomy was performed.
Histologically, the left robe nodule as well as the right lobe lesions
consisted of typical RDD cellular population, with the pathognomonic
phenomenon of emperipolesis. Infiltration to the periphery of the gland
was observed and three adjacent lymph nodes were also involved. The
uninvolved thyroid parenchyma showed changes compatible with chronic
autoimmune thyroiditis. No other localizations or systemic
manifestations of RDD were revealed. Normocalcemia was restored promptly
and the patient remains free of clinically overt disease one year
post-operatively. (J. Endocrinol. Invest. 22: 866-870, 1999) (C) 1999,
Editrice Kurtis
