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Bhatia A, Das S, Deka A, Sarma N, Tamuli P, Chakraborty S. Kimura Disease-A Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:2507-2510. [PMID: 37636657 PMCID: PMC10447794 DOI: 10.1007/s12070-023-03817-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 08/29/2023] Open
Abstract
Kimura Disease, an eosinophilic hyperplastic granulomatous disease of idiopathic origin is most commonly seen in young males. It mostly presents with deep subcutaneous tissue swelling along with enlargement of salivary glands and regional lymphadenopathy. Diagnosis is mainly based on histopathological findings and raised serum IgE and hypereosinophilia. The radiological investigation of choice is Magnetic Resonance Imaging. Management strategy includes surgery and steroid therapy. Chemotherapeutic agents are also frequently used by some centres. Relapse and recurrence stands to be a common problem with management of this disease process. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03817-y.
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Affiliation(s)
| | - Subhadeep Das
- Department of ENT, NEIGRIHMS, Shillong, 793018 India
| | - Anuradha Deka
- Department of ENT, NEIGRIHMS, Shillong, 793018 India
| | - Nayana Sarma
- Department of ENT, NEIGRIHMS, Shillong, 793018 India
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Kakehi E, Kotani K, Otsuka Y, Fukuyasu Y, Hashimoto Y, Sakurai S, Hirotani A, Simizu K, Fujita R, Shoji K, Adachi S, Matsumura M. Kimura's disease: effects of age on clinical presentation. QJM 2020; 113:336-345. [PMID: 31800058 DOI: 10.1093/qjmed/hcz312] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 11/11/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Kimura's disease (KD) is known to be dominant among young Asian men, but it can also occur in middle- and advanced-aged people. The clinical characteristics of KD, especially by age, are not well known. AIM This study was performed to investigate the effects of age on the clinical characteristics of KD. DESIGN We conducted a case series study. METHODS All case studies of patients diagnosed with KD were collected via a PubMed search of studies published until August 2018. The data were analyzed by age group. RESULTS In total, 215 studies were reviewed (238 patients; mean age of 36 years). The male:female ratio was 4:1 overall, 17:1 in patients aged <20 years, 4:1 in patients aged 20-39 years and 2:1 in patients aged ≥40 years (P = 0.01). The percentage of patients with pruritus was 15.4% overall, 3.8% in patients aged <20 years, 15.5% in patients aged 20-39 years and 21.7% in patients aged ≥40 years (P = 0.02). The time to diagnosis was 5.3 years overall, 3.2 years in patients aged <20 years, 4.7 years in patients aged 20-39 years and 7.1 years in patients aged ≥40 years (P < 0.01). CONCLUSIONS The proportion of female patients affected the incidence of pruritus, and the time to diagnosis increased as the patients' age increased. There were no significant age-related differences in region/race, complications, multiplicity, laterality, anatomical distribution, maximum size, eosinophil count, immunoglobulin E level, initial treatment, recurrence or outcomes. This may be useful information for the diagnosis of KD.
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Affiliation(s)
- E Kakehi
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - K Kotani
- Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Y Otsuka
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - Y Fukuyasu
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - Y Hashimoto
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - S Sakurai
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - A Hirotani
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - K Simizu
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - R Fujita
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - K Shoji
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - S Adachi
- Department of General Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori-City, Tottori, Japan
| | - M Matsumura
- Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
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Madakshira MG, Bajaj R, Kaur K. Warthin-Finkeldy cells - A soft indicator in cytodiagnosis of Kimura. J Cytol 2017; 34:154-155. [PMID: 28701829 PMCID: PMC5492753 DOI: 10.4103/joc.joc_16_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Manoj G Madakshira
- Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Rajat Bajaj
- Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Khushdeep Kaur
- Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India
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Ramteke P, Mallick S, Mathur S, Jain D, Iyer VK. Fine needle aspiration cytology from a postauricular swelling. Cytopathology 2017; 28:246-247. [PMID: 28198060 DOI: 10.1111/cyt.12420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- P Ramteke
- Department of Pathology, India Institute of Medical Sciences, New Delhi, India
| | - S Mallick
- Department of Pathology, India Institute of Medical Sciences, New Delhi, India
| | - S Mathur
- Department of Pathology, India Institute of Medical Sciences, New Delhi, India
| | - D Jain
- Department of Pathology, India Institute of Medical Sciences, New Delhi, India
| | - V K Iyer
- Department of Pathology, India Institute of Medical Sciences, New Delhi, India
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Sherpa M, Lamichaney R, Roy AD. Kimura's disease: A diagnostic challenge experienced with cytology of postauricular swelling with histopathological relevance. J Cytol 2016; 33:232-235. [PMID: 28028342 PMCID: PMC5156990 DOI: 10.4103/0970-9371.190453] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Kimura's disease is a rare, chronic inflammatory disorder of unknown cause. It is endemic in Asia, affecting more number of males than females, with a ratio of 3:1. The typical clinical manifestations include a triad of painless unilateral cervical lymphadenopathy or subcutaneous masses predominantly in the head and neck region, blood and tissue eosinophilia, and an elevated serum immunoglobulin E (IgE) levels. Variable conditions both benign and malignant may mimic Kimura's disease both clinically and on fine needle aspirates. The confirmatory diagnosis is established only by histopathological examination. We report a case of Kimura's disease in a patient who underwent multiple investigations in view of her past history and family history of pulmonary Koch's. Fine needle aspiration cytology (FNAC) was performed thrice with consistently similar result of reactive lymphadenitis with numerous histiocytes and eosinophilia. The final diagnosis of Kimura's disease could finally be established only on histopathological examination.
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Affiliation(s)
- Mingma Sherpa
- Department of Pathology, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
| | - Rachna Lamichaney
- Department of Pathology, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
| | - Asitava Deb Roy
- Department of Pathology, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
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Abstract
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.
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Affiliation(s)
- Sebastian J. Karavattathayyil
- Department of Pathology and Laboratory Medicine, Division of Hematopathology, Tulane University Medical Center, New Orleans
| | - John R. Krause
- Department of Pathology and Laboratory Medicine, Division of Hematopathology, Tulane University Medical Center, New Orleans
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Misselevich I, Luria M, Malatskey S, Fradis M, Podoshin L, Boss JH. Status of intraoperative cytology in the diagnosis of epithelioid hemangioma. Diagn Cytopathol 1998; 18:227-9. [PMID: 9523144 DOI: 10.1002/(sici)1097-0339(199803)18:3<227::aid-dc13>3.0.co;2-m] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Whereas evaluation of the frozen section of a subcutaneous retro-auricular mass was equivocal, the correct diagnosis of epithelioid hemangioma could be suggested on examination of intraoperative cytological smears. It is proposed that in the absence of cytological cues of malignancy and in the presence of the proper clinical setting, the constellation of vascular structures, eosinophils, lymphocytes, and clusters of cuboidal cells with vacuoles in their abundant acidophilic cytoplasm is indicative of epithelioid hemangioma.
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Affiliation(s)
- I Misselevich
- Department of Pathology, Bnai-Zion Medical Center, Haifa, Israel
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