Case report of sinus histiocytosis with massive cervical lymphadenopathy, Rosai-Dorfman disease in a child with serological findings of a recent Ebstein-Barr virus infection

We report a case of a very rare and benign disease, sinus histiocytosis with massive lymphadenopathy (SHML) in a child with serological findings of a EBV infection. A 4-year-old-boy was admitted with a huge bilateral solid and painless enlargement of the cervical lymph nodes and symptoms of mononucleosis. Histopathology and immunohistochemistry confirmed the diagnosis of SHML. Immunohistochemistry of Epstein-Barr virus expression in lymph nodes (EBNA2, ZEBRA, and LMP EBV) was carried out and the slides were negative. Epstein-Barr virus serological findings were as follows: IgM ANTI-VCA negative, IgG ANTI-VCA positive 180 Au/mL, IgM ANTI-EBNA negative and IgG ANTI-EBNA positive 250 Au/mL, IgG ANTI-EA negative. Peripheral blood smear microscopy revealed virus transformed lymphocytes. Following corticosteroid (methylprednisolon) therapy the boy reached a stable remission.