scholarly journals Kimura Disease of the Parotid Gland: Management Approach

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.

Author(s):  
Chandre Gowda Bendiganahalli Venkate Gowda ◽  
Madhuri Gandham

<p>Kimura’s disease (KD) is a rare chronic inflammatory disorder of unknown etiology, primarily seen in young Asian males. In India, only 200 cases have been reported worldwide since its histopathological diagnosis. The disease is characterized by painless subcutaneous swelling in head &amp; neck region, blood and tissue eosinophilia and raised Immunoglobulin E (IgE) levels. A systematic multidisciplinary approach is mandatory to rule out the other common causes of post auricular lymphadenopathy. The diagnosis of KD can be difficult and misleading and patients with this disease are often evaluated using avoidable procedures by just not being aware of KD. Here, we present a case of a 20 year old male who presented with nodular swellings in the bilateral post auricular region. The diagnosis of KD was done based on characteristic histopathologic finding in conjunction with peripheral eosinophilia.</p>


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.


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.


2021 ◽  
Vol 2 (1) ◽  
pp. 156-159
Author(s):  
Nupur Rastogi

Kimura disease is a benign rare chronic inflammatory disorder of unknown etiology. The disease is mainly endemic in Asia, cases have been reported in Europe and America. The present case is of a 75 year Indian male who presented with cervical and axillary lymphadenopathy. Ultrasonography was done which showed multiple peritoneal lymph nodes. Peripheral smear showed eosinophilia. Cytomorphology and histopathology showed features of Hodgkin’s disease. S IgE level was raised. 5 years earlier patient had presented with similar complaints of generalized lymphadenopathy, raised IgE level, peripheral eosinophilia. FNAC of cervical lymph node done earlier showed cytomorphology of Reactive Lymphadenitis. Biopsy showed histology of Kimura’s disease.


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.


Author(s):  
Ankur Batra ◽  
Megha Goyal ◽  
Sachin Goel ◽  
Lakshmi Vaid

<p>Kimura’s disease (KD) is a chronic inflammatory disorder with angiolymphatic proliferation of unknown etiology, usually affecting young men of Asian race but is rare in other races. Affected Indians are very rare. Herein, we present an atypical manifestation of Kimura’s disease occurring in an Indian male who presented with bilateral postaural lymphadenopathy. The diagnosis of Kimura’s disease can be very difficult and misleading; it is important not to ignore histopathological features.</p>


2021 ◽  
Vol 6 (2) ◽  
pp. 61-64
Author(s):  
Zalilah Musa ◽  
Abdul Razak Ismail ◽  
Irfan Mohamad

Introduction: Kimura disease is a rare chronic inflammatory disorder affecting the subcutaneous tissue. It is of unknown etiology mainly occurring in head and neck region. Case report: A 34-year-old Malay lady presented with a gradually enlarging, painless right nasal bridge mass for one year duration. Clinical examination revealed a firm, immobile swelling measuring 2 cm x 2 cm. Nasal endoscopy showed no extension of the mass into the right nasal cavity. Surgical excision was performed where histopathological examination reported as finding consistent with Kimura disease. Conclusion: Kimura disease is extremely a rare benign disease, which can affect the head and neck structures. Manifestation at the nasal region is an extremely rare occurrence. Histopathological examination is needed to diagnose the disease.


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.


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.


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