A 59-year-old female patient was admitted to our center complaining of upper abdominal pain, fatigue, and intermittent fever for the past 4 months. Her cancer antigen 125 (CA125) level was 143.8 U/mL. The computed tomography (CT) scan showed multiple low-density foci in the liver with arterial enhancement, suggestive of liver metastases (Figure 1A). Meanwhile, the positron emission tomography (PET)/CT scan demonstrated multiple FDG avid lesions in the liver with multiple enlarged lymph nodes in the left supraclavicular, mediastinal, supradiaphragmatic, hilar, and retroperitoneal regions, suggestive of liver and lymph nodal metastases (Figure 1B). The biopsy was inconclusive. Therefore, a tuberectomy of the left lateral lobe of the liver was performed (Figure 1C). The HE staining showed histiocytic and T-lymphocytic reactive or proliferative lesions (Figure 1D). The final pathological diagnosis was extranodal Rosai Dorfman disease. Afterward, the patient had no complaints, and after 7 months of follow-up, the liver CT scan revealed complete remission.
The authors thank Professor Wen-Rui Zhao providing help to this research.
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