FINE NEEDLE ASPIRATION CYTOLOGY

35yrs lady with multiple neck swellings for last 2 months.spot the diagnosis and discuss management.

male Child age 1 yr with hard swelling since 1 day as seen in pic , No fever , child playful .kindly help in diagnosis and treatment. ear examination normal, throat examination normal. no signs of RTI

50 years old female, with a 3 weeks history of recurrent intermittent fever. Precisely, one attack every week, but last time, the fever is persistent and reached 39.5 degrees. Also, the patient complaining of lymphadenopathy in the submandibular group and lymphadenitis in the axilla. She also complains of generalized weakness, fatigue, and loss of appetite and loss of weight. Recently (1 week ago) she had a painful skin lesion in her hand. No history of any other complains. Ix: Hb 12.7 WBC 10 Neutrophils 70 Lymphocyte 18 ESR 69 CRP 49 AST 54 ALT86 The investigations are attached, what do you think, please?

A 14 yrs old boy complaints bubble type lesion on his neck area he also has pain in it sometimes, this problem him for 6 months, it is soft on touching, please diagnos and do the needful।

18 yr old ,girl,college student,from neighbouring state,presented with painless swelling rt side of neck since 2 yrs *Chief Complaints* She developed neck swelling rt side 2 yrs ago Initially only single nodule ,slowly, the number of nodules increased.Denied having pain ,loss of weight or appetite / fever.The swelling is remaining static for the last 1 yr. Evaluated at her home town in different hospitals,biopsy done twice. After the biopsy she was informed that there is no further treatment available .She has no primary neurological problem.The reason to visit in the OPD is asking for a help to ref her to a proper doctor for further possible management at least for cosmetic reason. *History* No significant medical illness in the past.No family history of any type of malignancy .No history of TB in the family. *Vitals* Afebrile. BP110/ 60 mmhg.HR76/ mt. *Physical Examination* The only abnormality in physical exam is multiple mobile lymph nodes,varying in size,2 to 4 cm in the rt side of neck including submandibular lymph node ,some of them are matted together.No tenderness noted. No other lymphnode noted. No hepato-spleenomegaly noted. *Investigations* All blood work up including peripheral smear ,bone marrow,blood biochemistry,immunoelectrophoresis were normal.Ct chest and abdomen were normal. Cervical lymphnode biopsy done ,this is the3rd biopsy. *Diagnosis* 1st two biopsy report: Rosai Dorfman disease. *Management* Management waiting for the biopsy report. Question : What is the possible diagnosis ?