A Rare Case of Thymic Rosai-Dorfman Disease Mimicking Malignancy on 18F-FDG PET/CT

Background Rosai-Dorfman disease (RDD), the massive lymphadenopathy characterized by the proliferation of sinus histiocytosis, is a relatively idiopathic benign disease with unknown etiology. We reported a rare case of thymic RDD detected by F-18-FDG PET/CT. A 23-year-old man with right-sided chest pain underwent F-18-FDG PET/CT scan, showing increased F-18-FDG uptake in an anterior mediastinal mass corresponding to a thymic lesion at an enhanced CT scan. The patient was referred to surgery with the clinical suspicion of thymic malignancy. The histological examination and immunohistochemical results confirmed RDD. Conclusions This was the first case report of RDD isolated to the thymus and initially presented with chest pain. Moreover, there was no characteristic painless neck lymphadenopathy at any stage of the disease course. Thus, for young patients with thymus mass, RDD should be considered a rare but possible diagnosis.

Automated summary

We reported a rare case of thymic Rosai-Dorfman disease (RDD) that initially presented with chest pain and did not show typical painless neck lymphadenopathy throughout the disease course. RDD should be considered as a possible diagnosis for young patients with thymic masses.