Atypical presentation of a Sinus histiocytosis with massive lymphadenopathy (Rosai Dorfman disease) with granulomas - Post COVID-19 infection

A 51-year-old gentleman developed a rapidly progressing inguinal mass three months post corona virus disease (covid-19) infection. On examination, there was generalized lymphadenopathy confirmed by CT scans and a lymphoma was suspected. On light microscopy there were features of Rosai Dorfman disease with associated necrotizing granulomas amidst the large cells in the sinusoids, which have not been described before in Rosai Dorfman disease. Gene x-pert for tuberculosis, bacterial, fungal and acid fast bacilli cultures were negative. We present this case report for documenting this presentation post COVID-19 infection with review of literature.