Rosai-Dorfman Disease in Nasal Cavity and Paranasal Sinuses: Imaging Features in a Series of 23 Patients.

Abstract

To analyze the CT and MRI features of Rosai-Dorfman disease (RDD) in nasal and paranasal sinuses. The CT and MRI images of 23 patients with RDD were retrospectively analyzed. The 23 patients included 10 men and 13 women, with a mean age of 43.4 years. Among the 23 cases, only 3 cases (13.0%) had unilateral lesions, and 20 cases (87.0%) had lesions involving bilateral nasal and/or paranasal sinuses. In some patients, the lesions were limited to the nasal and paranasal sinuses (8 cases), while in some patients, the lesions invaded the surrounding tissues (15 cases). 11 patients (47.8%) had enlarged lymph nodes in the retropharynx, parotid gland, and neck. The lesions showed isodense on CT images, accompanied by mild bony absorption and hyperostosis. The lesions showed isointensity on T1WI, mainly hypointensity to isointensity on T₂WI, and a few showed hyperintensity. After enhancement, the lesions showed moderate to obvious enhancement, and the enhancement was homogeneous without necrosis. The diffusion of the lesion was limited on diffusion-weighted imaging, and the average apparent diffusion coefficient value was 674.5 × 10^-3 mm²/s. Dynamic enhanced MRI showed a rapidly enhancing and slow washout pattern of time-intensity curve. The possibility of RDD should be considered when a bilateral diffuse mass growing along the nasal mucosa is found, with low T₂ signal, limited diffusion, no necrosis, and slight bone destruction and sclerosis.