With Massive Lymphadenopathy and Other Rare Pseudotumours

ly, the histiocytes are strongly positive for S-100 protein and Leu-M1. No nuclear and cytoplasmic atypia is observed.

Differential diagnosis includes infectious diseases (rhinoscleroma), Wegener's granulomatosis, NK/T lymphoma of the nasal type, eosinophilic granuloma, Hodg-kin's lymphoma and fibroinflammatory disorders. Rhi-noscleroma is characterised by a proliferation of large macrophages (Mikulicz cells) in which Klebsiella rhi-noscleromatis can be identified. In this disease the phenomenon of emperipolesis is not found. Histological-ly, in Wegener's granulomatosis the S-100 positive his-tiocytes are lacking, while NK/T lymphoma of the nasal type shows an infiltration of malignant lymphoid cells. Eosinophilic granuloma is histologically similar to Rosai-Dorfman disease, but differentiation is possible with the morphologic specificities of the Langerhans cells, characteristic of eosinophilic granuloma: their nuclei show lobulation, indentation or longitudinal grooving. Finally, fibroinflammatory lesions, such as aggressive fibromatosis, can be easily differentiated due to the relatively acellular appearance compared with the characteristic cellular infiltration in Rosai-Dorfman disease [381].

Some rare laryngeal lesions may clinically and pathologically mimic neoplastic growth and could be ranged in a category of pseudotumours: hamartoma [282, 314], warty dyskeratoma of the vocal cord [178], and Kimura disease of the epiglottis [58].

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