Persistent Generalized Lymphadenopathy: A Diagnostic Conundrum—Case Report and Review of Literature

Abstract

Generalized lymphadenopathy is a nonspecific sign with heterogenous etiology including infective, inflammatory, and malignant causes. We present the case of a child who presented with generalized lymphadenopathy, involving the cervical, axillary, mediastinal, and inguinal groups, along with recurring fever, tonsillar enlargement, and parotid swelling for 2 years. She had coexisting undernutrition and hepatosplenomegaly on examination. After ruling out common infective causes like tuberculosis, autoimmune and neoplastic conditions were considered. The diagnosis was made by histopathology of the axillary node biopsy, which revealed characteristic features of Rosai–Dorfman disease (RDD). She was started on oral steroids but was lost to follow-up after 6 months. We report this case to emphasize that RDD, a subtype of non-Langerhans histiocytosis, should be considered as a differential in young patients with persistent generalized lymphadenopathy.

Keywords

• histiocytosis
• emperipolesis
• lymphadenopathy
• steroids