Head and neck tumours: Rosai-Dorfman disease: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Head and neck tumours: Rosai-Dorfman disease

Sample item

A 12-year-old boy has massive painless bilateral cervical lymphadenopathy with fever and a raised ESR. Node biopsy shows sheets of S100-positive histiocytes engulfing intact lymphocytes. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Rosai-Dorfman disease

Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) presents with huge painless bilateral cervical nodes. Histiocytes show emperipolesis, are S100 positive and CD1a negative. Langerhans cell histiocytosis is CD1a positive.

Option by option

  • A. Hodgkin lymphoma

    Hodgkin lymphoma shows Reed-Sternberg cells in a mixed infiltrate.

  • B. Rosai-Dorfman disease (correct)

    Correct. Emperipolesis by S100-positive histiocytes in a boy with massive cervical nodes is Rosai-Dorfman disease.

  • C. Tuberculous lymphadenitis

    Tuberculous lymphadenitis shows caseating granulomas with matted nodes.

  • D. Langerhans cell histiocytosis

    Langerhans cell histiocytosis shows grooved nuclei, CD1a positivity and Birbeck granules.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Rosai-Dorfman disease. Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) presents with huge painless bilateral cervical nodes.

Why is "Hodgkin lymphoma" not the answer?

Hodgkin lymphoma shows Reed-Sternberg cells in a mixed infiltrate.

Why is "Tuberculous lymphadenitis" not the answer?

Tuberculous lymphadenitis shows caseating granulomas with matted nodes.

Why is "Langerhans cell histiocytosis" not the answer?

Langerhans cell histiocytosis shows grooved nuclei, CD1a positivity and Birbeck granules.

What concept does this question test?

It tests Head and neck tumours: Rosai-Dorfman disease in ENT. Histiocytes show emperipolesis, are S100 positive and CD1a negative. Langerhans cell histiocytosis is CD1a positive.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck tumours: Rosai-Dorfman disease?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.