![]() She was started on a tapering dose of corticosteroids and showed clinical improvements over the next few weeks. Supraclavicular lymph node biopsy showed Rosai–Dorfman disease with a marked polyclonal plasmacytosis. Laboratory results were consistent with lymphopenia, anemia, and an elevated sedimentation rate. Approximately 3 months later, she developed a generalized patchy erythematous rash on the face and the body that gradually worsened diffuse lymphadenopathy involving the bilateral cervical, axillary, and inguinal areas and constitutional symptoms. ![]() ![]() Her symptoms were mild and self-resolving. Approximately 2 months later, she developed mild flu-like symptoms and was diagnosed with a COVID-19 infection. The biopsy of the skin rash was consistent with a drug reaction. A 55-year-old Asian-American woman with no significant medical history or recent use of new drugs initially presented with cervical lymphadenopathy and urticarial rash 1 week after receiving the COVID-19 messenger RNA (mRNA) vaccine (Moderna, mRNA-1273) against SARS-CoV-2. Rosai–Dorfman–Destombes disease (RDD) is an unusual non-Langerhans cell (non-LC) histiocytosis presenting with massive lymphadenopathy and various systemic symptoms. 2Department of Pathology, SUNY Downstate Health Sciences University, Brooklyn, NY, United StatesĬoronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to cause immune dysregulation and, therefore, has varied and often rare presentations.1Department of Hematology and Oncology, Maimonides Medical Center, Brooklyn, NY, United States.Pooja Gogia 1 * Fahmina Tanni 1 Juan Coca-Guzman 2 Neil Chen 1,2 Yiwu Huang 1
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