A 52-year-old female patient complaining of progressive nasal obstruction six months ago, nasopharyngoscopy revealed a nasopharyngeal large fleshy non-pulsatile mass, ear examination and tympanometry revealed left middle ear effusion without any abnormalities in mouth or oropharynx. There was no enlarged cervical lymphadenopathy in contrast to most RDD cases. Given clinical examination and radiological findings, an excisional biopsy was done under general anaesthesia with left ear ventilation T-tube insertion. Histopathological examination of the biopsy specimen reveals a unique histopathological feature, “emperipolesis”, and immunohistochemistry confirmed the diagnosis of Rosai-Dorfman Disease.
