Painless cervical lymphadenopathy in an elderly patient – a rare case of Rosai-Dorfman disease and Hodgkin's lymphoma

Rosai-Dorfman disease (RDD) is a rare, benign disease with extensive lymphadenopathy. In this case, an 81-year-old gentleman with previous pulmonary tuberculosis presented painless cervical lymphadenopathy associated with generalized weakness, loss of appetite, and cough. The causes of cervical lymphadenopathy in the elderly are comprehensive; thorough history, examination, and appropriate investigations are vital in diagnosing diseases. A lymph node biopsy is recommended if blood investigations and imaging are inconclusive. He was later diagnosed with RDD associated with Hodgkin’s lymphoma, and dexamethasone treatment was initiated. Concomitant diagnoses are rare but should not be disregarded. This case report is a reminder that RDD remains a differential diagnosis of cervical lymphadenopathy. Regular monitoring is required as immune dysregulation from the treatment of RDD may exacerbate quiescently treated pulmonary tuberculosis.