scholarly journals Kimura’s disease: a diagnostic and therapeutic enigma

Author(s):  
Vinay Bharat ◽  
Abhishek Gupta ◽  
Rani Bansal ◽  
Priya Gupta ◽  
Mamta Gupta

Kimura’s disease is a rare chronic inflammatory disorder present in 2nd and 3rd decade. It has a predilection for head and neck region presenting as a slowly growing painless swelling. It is usually accompanied by peripheral eosinophilia and elevated serum IgE and hence it was initially thought to be of allergic origin. Histologically the lesions are characterized by reactive hyperplasia of lymph nodes, eosinophilic infiltration and increase in postcapillary venules. Authors have reported a male patient with a slowly growing right sided neck swelling which is recurring even after course of steroids and excision done twice at an interval of 6 months. Kimura’s disease although a benign Lymphoid disorder but the incidence of recurrence despite taking treatment is a cause of much concern for the patient.

2021 ◽  
Vol 14 (1) ◽  
pp. e232627
Author(s):  
Jacqueline Ho ◽  
Sophie Walter ◽  
Richard J Harvey

Kimura’s disease is a rare, benign, chronic inflammatory disorder characterised by its eosinophilic infiltrate. Patients often present with one or more progressively enlarging subcutaneous lymph nodes in the head and neck region or enlarging salivary glands. We describe the case of a 26-year-old man presenting with severe peripheral eosinophilia and upper airway inflammatory symptoms, who later developed cervical lymphadenopathy and formally diagnosed with Kimura’s disease. Based on our English-language MEDLINE literature search, to our knowledge this is the first case report describing treatment of Kimura’s disease with mepolizumab.


2020 ◽  
Vol 6 (4) ◽  
pp. 20200099
Author(s):  
Célia Peixoto Sousa ◽  
Elsa Fonseca ◽  
Bárbara Viamonte ◽  
João Calheiros Lobo ◽  
António Madureira

Kimura’s disease is an uncommon inflammatory disorder of unclear aetiology, mainly affecting young Asian descent males among their second and fourth decades of life. The disease typically emerges as a long-standing and painless subcutaneous mass lesion in the head and neck region, frequently associated with swelling of major salivary glands, particularly the parotid gland, and regional lymphadenopathy. Peripheral eosinophilia and high serum immunoglobulin E are also characteristic findings. We report a case and describe the imaging and pathological features of the disease in a 19-year-old Caucasian male, with review of the literature.


2000 ◽  
Vol 79 (3) ◽  
pp. 195-199 ◽  
Author(s):  
Sebastian J. Karavattathayyil ◽  
John R. Krause

Kimura's disease is a rare, idiopathic condition that usually affects young men of Asian descent. The disease is characterized by swelling and lesions in the head and neck region, with involvement of the subcutaneous soft tissue, major salivary glands, and lymph nodes. Patients almost always have eosinophilia and elevated serum immunoglobulin E levels. The diagnosis is established by biopsy. Kimura's disease is usually self-limiting. Its etiology is unknown but is thought to be a manifestation of an aberrant allergic response. In this paper, we describe the case of a 30-year-old patient who was diagnosed with Kimura's disease at our institution.


2020 ◽  
Vol 13 (10) ◽  
pp. e236366
Author(s):  
Prasanna Kumar Saravanam ◽  
Aishwarya Gajendran ◽  
Nethra Dinakaran ◽  
Dhaarani Jayaraman

Kimura’s disease is a chronic inflammatory disorder involving subcutaneous tissue and locoregional lymph nodes of head and neck region, characterised by angiolymphoid proliferation. It is typically associated with peripheral eosinophilia, increased serum IgE and lymphadenopathy. Diagnosis is usually based on histopathological examination. Though various treatment modalities have been put forward, surgical management remains the first line of treatment, followed by systemic steroids application. This case report discusses the diagnostic dilemma and therapeutic management of a rare clinical presentation and management of oropharyngeal Kimura’s disease in a young immunocompetent woman.


2021 ◽  
pp. 116-123
Author(s):  
Roald Vissing-Uhre ◽  
Alastair Hansen ◽  
Susanne Frevert ◽  
Ditte Hansen

Kimura disease (KD) is a chronic, inflammatory disorder with slowly developing subcutaneous tumor-like swellings, often occurring in the head and neck region. KD is diagnosed based on histology, elevated levels of immunoglobulin type E, and increased peripheral eosinophil granulocytes. KD may coexist with glomerular renal diseases, and this case report is based on a patient with KD-associated membranous nephropathy. Patients with membranous nephropathy without KD have demonstrated responsiveness to treatment with monoclonal anti-CD20 antibodies. This case report is the first to investigate the effect of rituximab treatment in a patient with KD-associated membranous nephropathy. A 30-year-old Italian man living in Denmark was diagnosed with Kimura’s disease based on subcutaneous nodules with eosinophil angiolymphoid hyperplasia. The patient was admitted to the hospital due to nephrotic syndrome. Serology showed eosinophil granulocytosis and negative PLA2-receptor antibody. Renal biopsy showed membranous nephropathy, and the patient was treated with systemic methylprednisolone followed by cyclosporin and then cyclophosphamide with only partial remission. Ultimately, treatment with intravenous rituximab was initiated, which resulted in overall remission and no nephrotic relapses at 30 months of follow-up. Thus, intravenous rituximab effectively decreased proteinuria and prevented nephrotic relapses in a patient with treatment-refractory membranous nephropathy due to KD.


2022 ◽  
Vol 4 (1) ◽  
pp. 01-03
Author(s):  
Hafeza MS ◽  
Vanitha Palanisamy

Here we present a 43-years old Malay man with Kimura’s disease of the right parotid gland. Asian men have a predisposition for this chronic inflammatory disorder of unknown etiology mostly presenting at the head and neck region. The management in dealing with this patient is not straight forward as the presentation mimics a subcutaneous tumor-like mass in which main differential diagnosis includes lymphoproliferative disorders and parotid neoplasm. Moreover, cytological investigation is inadequate, and this necessitates the use intra-operative frozen section prior to tumor debulking. Without proper investigation, misdiagnosis can occur and potentially expose the patient to unnecessary extensive surgical procedures. Here we discuss step by step approach in managing this patient.


2019 ◽  
Vol 101 (5) ◽  
pp. 309-312
Author(s):  
C Samian ◽  
S Ghaffar ◽  
V Nandapalan ◽  
S Santosh

Introduction Malakoplakia is a rare chronic inflammatory disorder, predominantly affecting the urinary tract. In the head and neck region, it is very rare and may confuse the clinicians during investigations, as features may mimic malignancy. Materials and methods We report a case of malakoplakia involving the parotid gland and review of the reported cases of malakoplakia in head and neck region. Results Histologically, this is the first classic case report of malakoplakia involving the parotid gland in the world literature. A total of 49 cases have been reported in the head and neck region; 38.7% of these are cutaneous. In soft tissue, the tongue is the most common site. Salivary gland involvement is very rare. Previously, submandibular salivary gland involvement has been reported. Conclusion A possibility of malakoplakia should be considered as a differential diagnosis in patients with enlarged head and neck masses. Histology is essential to diagnose this benign inflammatory disorder and to differentiate from a malignant process.


2021 ◽  
Vol 16 (2) ◽  
pp. 259-265
Author(s):  
V Sha Kri Eh Dam ◽  
Irfan Mohamad ◽  
Evelyn Li Min Tai ◽  
Adil Hussein ◽  
Khairil Amir Sayuti ◽  
...  

Kimura disease (KD) is a rare chronic inflammatory disorder of unknown aetiology that primarily affects the head and neck region with lymph node involvement. Young to middle-aged adult Asian males are predominantly affected. The most common presentation is painless subcutaneous swelling in the head and neck region, while proptosis or orbital involvement is very rarely reported. KD shares some features with other inflammatory and neoplastic disorders, including lymphoma; thus, investigations to confirm the diagnosis should not be delayed. Systemic corticosteroids are commonly used to treat KD and show an excellent response; however, the optimal treatment is still uncertain, and KD has a high recurrence rate. We describe the case of a patient with KD who presented with proptosis and post-auricular swelling, which responded well to oral prednisolone treatment.


Author(s):  
Aarti S. Salunke ◽  
Ravindranath B. Chavan ◽  
Vasudha A. Belgaumkar ◽  
Neelam Bhatt

<p style="margin-bottom: 0in; line-height: 100%;" align="JUSTIFY">Kimura’s disease is a rare chronic inflammatory disease of unknown etiology, presenting as painless subcutaneous nodules with lymphadenopathy and peripheral eosinophilia, mainly disturbing the head and neck region. It mainly affects Asian males in their 2nd to 4th decade of life. Kimura’s disease, although difficult to diagnose clinically, should be considered in the differential diagnosis of patients who have a primary lymphadenopathy with eosinophilia with or without subcutaneous nodules. It should be investigated accordingly as the disease has an indolent course and good prognosis. Herein we report two cases of Kimura’s disease, of which one had unusual site of involvement. </p>


2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Cláudia Savassi Guimaraes ◽  
Natalie Moulton-Levy ◽  
Allen Sapadin ◽  
Claudia Vidal

Kimuras disease is a chronic inflammatory disorder of unknown etiology. It is rare in the West, but endemic in Asia. It typically presents as solitary or multiple subcutaneous nodules, that slowly increase in size. The lesions are variably painful and pruritic. It often accompanied by regional lymphadenopathy, raised serum eosinophil counts, and markedly elevated serum immunoglobulin E levels. Histologically, the lesions are characterized by reactive lymphoid follicles with eosinophilic infiltration and an increased amount of postcapillary venules. The optimal treatment for KD remains controversial. Although the condition seldom resolves spontaneously, malignant transformation has not been reported to date, and the prognosis is good. We describe a male patient with a 4-year pruritic progressive “bump” in front of his left ear. On physical examination, the patient had 2 discrete lesions on the left side of his face near his ear. Postauricularly, there was a3×5cm erythematous to violaceous, indurated nodule. Preauricularly, there was a similar, but smaller cyst-like nodule. Punch biopsy showed a superficial and deep nodular and interstitial infiltrate, reactive lymphoid follicles with a dense infiltration of eosinophils and areas of eosinophilic follicle lysis. The patient received intralesional triamcinolone acetonide injections 10 mg/cc behind left ear with a good improvement.


Sign in / Sign up

Export Citation Format

Share Document