Chest xray confirmed the absence of any pathology including hilar lymphadenopathy. It was first described in 1937 in chinese medical literature by kim and szeto and later definitive histological description was published by kimura et al. In about 12% of patient, there may be associated renal disease, usually presenting as proteinuria. A palpable lymph node of size more than 1 cm diameter is usually. Kimuras disease journal of oral and maxillofacial pathology. Tsukadaira a, kitano k, okubo y, horie s, ito m, momose t, et al. The dense eosinophil collection in the lymph node raised a possibility of kimuras disease because no worms were seen in the initial sectioning of the tissue. The most common clinical feature of this disease is an asymptomatic unilateral softtissue mass in the head and neck. Kimura s disease is a lymphadenopathy that usually involves the head and neck region with a predilection for young adult asian men. The dense eosinophil collection in the lymph node raised a possibility of kimura s disease because no worms were seen in the initial sectioning of the tissue. Kimuras disease kd was firstly described in a chinese literature in 1937,1 and its histological description was produced by kimura et al in 1948 which has given its name 2. The surgical margins were noted to be clear of disease.
In addition, multiple lymph nodes were palpated in the. Kimura s disease is an important category of reactive lymphadenopathy in the oriental population. Kimuras disease was first described in hina in 1937, but it was not referred to as kimuras disease until its description in the japanese literature in 1948. The histopathology was characteristic and the patient had stable disease on. Rare chronic inflammatory disorder involving deep subcutaneous tissue of head and neck, often with lymphadenopathy and salivary gland involvement. Kd occurs mainly in the head and neck, but development in the axillary region is very rare. She was found to have generalised lymphadenopathy and a fineneedle aspiration cytology initially done revealed reactive lymphadenitis which was inconclusive. Kimuras disease as a solitary intrapulmonary lymphadenopathy. An unusual clinical presentation of kimuras disease. Microscopic analysis indicated that kd mainly involved subcutaneous soft tissue and lymph nodes.
May 15, 2011 the dense eosinophil collection in the lymph node raised a possibility of kimura s disease because no worms were seen in the initial sectioning of the tissue. It is benign condition with unknown etiology usually affecting young men of asian race. Salient pathological changes include florid germinal centers, warthinfinkeldey type polykaryocytes, vascularization of germinal center. Kimura disease, also known as eosinophilic hyperplastic lymphogranuloma, is a rare benign inflammatory disease that characteristically manifests as enlargement of cervical lymph nodes and salivary glands. Eosinophilic peritonitis and nephrotic syndrome in kimura. The diagnosis of kimuras disease was established only on histopathology of the excised axillary lymph node. The eccentrically located fat signal and signal void dots suggested pathology of a lymph node preserving nodal archtecture or fatty mass with an unusual. Kimuras disease involving the head and neck region and upper extremities have been documented 38. Lymph node enlargement is recognized as a common sign of infectious, autoimmune, or malignant disease. Kimuras disease in subcutaneous, parotid and lymph nodes sah. We report here a case of kimuras disease in the groin with mr imaging findings and histopathological correlations. It primarily involves the head and neck region, presenting as deep subcutaneous masses and is often accompanied by regional lymphadenopathy and salivary gland involvement.
Superficial lymph nodes and parotid glands are sometimes involved. Kimuras disease was further characterized by eosinophilic folliculolysis. This may rarely be encountered in children, and the knowledge of this fact is essential to rule out the remote possibility of kimuras disease in children with a slowgrowing painless mass in. Kimura s disease is a rare, benign chronic inflammatory condition which commonly occurs among the oriental population. We present a case of a young female presenting with unilateral, chronic, cervical and axillary lymphadenopathy. Kimura s disease kd is a rare, chronic inflammatory disorder of unknown cause.
We report a case of kimuras disease in a 65yearold woman who presented with generalised itching, abdominal pain, facial puffiness, difficulty in swallowing and loss of appetite. It occurs predominantly in young adults with the age range of 2740 years and the male to female ratio is 3. Although it is rare, most cases of kimuras disease have originated in china, japan, or southeast asia, and the disease is uncommon in caucasians and rare in africans. Kimura disease is a benign rare chronic inflammatory dis order of unknown etiology that involves the lymph nodes and subcutaneous tissue of the head and. Microfilaria in lymph node mimicking kimura disease. Kimuras disease, axillary lymph nodes, eosi nophilic granuloma, igerist, biopsy background kimuras disease kd. Kimuras disease, including acute interstitial nephritis, lymphoma, polyneuropathy, organomegaly, endocrinopathy, monoclonal protein and skin syndrome poems, igg4 related disease. Kimura s disease was further characterized by eosinophilic folliculolysis. Pdf kimuras disease is a rare chronic inflammatory condition of uncertain etiology which has an affinity for the asian population. Most cases have been reported in young, 2030yearold men of asian descent. Pathology of lymph node enlargement 03 authorstream. High levels of circulating eosinophilic cationic protein and major basic protein and high tissue ige concentrations also have been found in the active stage of kimuras disease.
Involvement of regional lymph nodes and distinction from angiolymphoid hyperplasia with eosinophilia. The diagnosis of kimura s disease was established only on histopathology of the excised axillary lymph node. Key words kimuras disease, mesenteric lymph node introduction abdomen. Case report open access kimuras disease affecting the axillary lymph nodes. Kimuras disease is a rare autoimmune disease of unrecognized etiology. Histologically kimura s disease presents as preserved lymph node architecture with reactive and prominent germinal centers. Pdf kimuras disease an unusual presentation involving. Kimuras disease, orientals, head and neck, nodules, lymphadenopathy introduction kimuras disease kd was first described in chinabyszeto in 1937 and later reported by kimura in japan in 1948 1 the etiology of kd is still unknown and once thought to be a disease that affected only orientals, but it also occurs sporadically in caucasians. It is considered to be due to chronic inflammation of unclear etiology. Typical clinical presentations are painless subcutaneous masses, regional lymph node enlargement, blood and tissue hypereosinophilia, and increased serum ige levels. Its primary symptoms are subdermal lesions in the head or neck or painless unilateral inflammation of cervical lymph nodes. Kimuras disease is a chronic inflammatory condition producing subcutaneous tumourlike nodules chiefly in the head and neck region. Sep 12, 2006 immunohistochemical stain demonstrating the intact dendritic meshwork in a lymph node involved by kimura disease immunoglobulin e, original magnification.
Pathology of lymph node enlargement 9 auricular erysipelas herpes zoster rubella squamous cell ca styes or chalazion tularemia lymphoma leukemia axillary breast cancer local infection lymphomas mastitis occipital lymphoma leukemia roseola scalp infections sebor. Case report kimura s disease in a caucasian female. The disease is characterized by a triad of painless subcutaneous masses in the head or neck region, blood and tissue eosinophilia, and markedly elevated serum immunoglobulin e levels. Kimuras disease an unusual presentation involving subcutaneous tissue, parotid gland and lymph node parul sah 1, abhay kamath 2, chithra aramanadka 2, raghu radhakrishnan 1 1 department of oral and maxillofacial pathology, manipal college of dental sciences, manipal, karnataka, india 2 department of oral and maxillofacial surgery, manipal college of dental sciences, manipal, karnataka, india. Kimuras disease with eosinophilic panniculitis treated. Spontaneous involution is rare and the main concern is its capacity to grow and cause disfigurement. Chronic inflammatory disorder of unknown etiology endemic in asia, affects young men often subcutaneous mass of head and neck including salivary glands, associated with regional lymphadenopathy but normal overlying skin. Clinical analysis of kimuras disease in 24 cases from china bmc. Eosinophilic peritonitis and nephrotic syndrome in kimuras. Kimuras disease has a benign clinical course with a triad of features. To the best of our knowledge, a report of kimuras disease involving the groin in the english language has not been reported. Dense eosinophilic in ltration of the interfollicular zones, lysis of the follicles, and occasionally microabscesses are seen. Unusual and rare case of generalised lymphadenopathy.
Kimura disease kd is a chronic inflammatory disorder with angiolymphatic proliferation, usually affecting young men of asian race but is rare in other races. Kimuras disease an exclusive condition gurram p, chandran. Kimuras disease is a lymphadenopathy that usually involves the head and neck region with a predilection for young adult asian men. We describe an 11yearold asian boy with kimuras disease who presented with a chronic left neck mass. Kimura s disease is a rare disorder that affects the subcu taneous tissue and. Major salivary glands and lymph nodes may also be involved. Kimuras disease is a rare, chronic inflammatory disorder of unknown cause, primarily seen in young asian males. Kimuras disease is an important category of reactive lymphadenopathy in the oriental population.
Salient pathological changes include florid germinal centers, warthinfinkeldey type polykaryocytes, vascularization of germinal centers, increased postcapillary venules in the. Microfilaria in lymph node mimicking kimura disease europe. A 74yearold japanese woman was evaluated for a mass that she noted in the left axillary region. Kimuras disease is a rare chronic inflammatory condition of uncertain etiology which has an affinity for the asian population. In this case, lymph node pathology and renal biopsy plays an important role in distinguishing it from other diseases.
Kimuras disease of the parotid glands and multiple cervical lymph. This rare case highlighted the clinical conundrum of a patient presenting with eosinophilic peritonitis, lymphadenopathy, nephrotic syndrome and renal failure associated with kimuras disease. Kimuras disease with atypical musculoskeletal presentation. Kimuras disease kd is a rare, benign disorder characterized by subcutaneous masses with regional lymphnode enlargement. Kimuras disease is a rare, benign, slow growing chronic inflammatory swelling with a predilection for the head and neck region and almost always with peripheral blood eosinophilia and elevated serum ige levels. It mainly involves the lymph nodes and subcutaneous tissue of head and neck region. The eosinophilic infiltration, especially the formation of eosinophilic microabscesses, along with increased number of small blood vessels. Kimuras presenting as a soft tissue swelling in nose without any nodal involvement. The remarkable eosinophilia, pathology of lymph node and kidney, as well as significant response to steroids should guide towards the diagnosis. Kimuras disease of the nose an unusual presentation. Peripheral blood eosinophilia and elevated serum immunoglobulin e ige levels are. It is characterized histologically by lymphoid follicles, intense aggregations of eosinophils, vascular proliferation and fibrosis. Jeffrey medeiros, in diagnostic surgical pathology of the head and neck second edition, 2009. Herein, we present an atypical manifestation of kimura disease occurring in a caucasian man with steroidresponsive early membranous glomerulonephritis.
Kimuras disease kd is an uncommon, benign, chronic. A case of pathophysiologic study in kimuras disease. Kimuras disease is a benign, chronic inflammatory soft tissue disorder of unknown origin. Kimuras disease is a rare chronic inflammatory disorder characterized by the head and neck lymphadenopathy often accompanied by eosinophilia and elevated serum ige. Kimuras disease is a rare, benign chronic inflammatory condition which commonly occurs among the oriental population. Kimura disease, reactive lymphadenopathy, follicular. The enlarged nodes are mostly located in the head and neck region. Characteristic pathological features include intact lymphnode. It is similar to angiolymphoid hyperplasia with eosinophilia. Kimura s disease is a benign rare chronic inflammatory disorder. Kimura s disease an unusual presentation involving subcutaneous tissue, parotid gland and lymph node parul sah 1, abhay kamath 2, chithra aramanadka 2, raghu radhakrishnan 1 1 department of oral and maxillofacial pathology, manipal college of dental sciences, manipal, karnataka, india 2 department of oral and maxillofacial surgery, manipal.
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