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Le LN, Tran LNT, Pham DL. Kimura disease: A rare case in Vietnamese woman. Asia Pac Allergy 2024; 14:143-147. [PMID: 39220575 PMCID: PMC11365659 DOI: 10.5415/apallergy.0000000000000134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 12/20/2023] [Indexed: 09/04/2024] Open
Abstract
Kimura disease (KD) is a rare benign chronic inflammatory condition that predominantly affects Asian males. It is characterized by subcutaneous tissue masses in the head and neck region, enlarged lymph nodes, increased blood eosinophilia, and elevated serum total IgE levels. In this report, we describe a rare case of KD in a young Vietnamese female. A 31-year-old Vietnamese woman presented to the hospital with 2 masses in the bilateral cheeks and 1 mass behind the left ear that persisted for 15 years, recurrent skin itching, elevated serum total IgE levels, and increased blood eosinophilia. No medical history of the individual or family was recorded. We performed an excision biopsy of the postauricular mass that revealed follicular hyperplasia with small vessel hyperplasia, diffuse infiltration of eosinophils in lymphoid follicles, and several eosinophilic microabscesses. After a comprehensive review, the final diagnosis for this patient was KD and atopic dermatitis comorbidity. In conclusion, KD is not limited to males, as this report demonstrated. The histopathological examination plays an important role in the diagnosis of KD. This case illustrated the characteristic description of KD and highlights the need for awareness of this rare disease in Asian women.
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Affiliation(s)
- Linh Nguyet Le
- Department of Dermatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Linh Ngoc Tuong Tran
- Department of Otorhinolaryngology, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Duy Le Pham
- Department of Physiology, Pathophysiology & Immunology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Allergy & Clinical Immunology Unit, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
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2
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Fenech M, Ajanaku A, McCormick A, Coupland SE, Krishna Y, Sultan Z, Ghadiri N. Orbital Kimura disease: maintenance therapy using mycophenolate mofetil. Orbit 2024:1-8. [PMID: 38815210 DOI: 10.1080/01676830.2024.2358061] [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: 04/01/2024] [Accepted: 05/15/2024] [Indexed: 06/01/2024]
Abstract
Kimura disease (KD) is a rare, chronic, inflammatory condition, predominantly found in male patients of Asian ethnicity. It typically presents between 50-60 years of age and usually with bilateral disease. Angiolymphoid hyperplasia with eosinophilia (ALHE) remains the main differential diagnosis, although histological analysis is essential in differentiating from other similarly presenting pathologies. In this case, we present an atypical case of unilateral orbital KD in a middle-aged, Caucasian, male gentleman and no evidence of regional lymphadenopathy along with a literature review of orbital KD and the differential diagnoses, histological features and management modalities available, adding to the sparse literature on the topic. At present, no recognised diagnostic criteria for KD are available, with histopathological analysis through incisional or excisional biopsy being the primary diagnostic method. Complete surgical excision with or without corticosteroid management remains the most common treatment modality although management is shifting to steroid-sparing immunomodulatory therapy. To the best of our knowledge, this is the first case to describe maintenance therapy of KD using mycophenolate mofetil.
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Affiliation(s)
- Matthew Fenech
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Ayodeji Ajanaku
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Austin McCormick
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Sarah E Coupland
- Department of Histopathology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Yamini Krishna
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Ziyaad Sultan
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Nima Ghadiri
- Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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3
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Negre GCMP, Regala FG, Ang CY, Tumalad MA. Kimura Disease: A case report with bilateral upper lid masses and a right parotid mass. Orbit 2023; 42:624-629. [PMID: 35436175 DOI: 10.1080/01676830.2022.2058022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 03/20/2022] [Indexed: 10/18/2022]
Abstract
A 38-year-old male presented with bilateral upper eyelid masses and a right parotid mass. Nineteen years before the consultation, the patient experienced swelling at both upper eyelids. Formerly diagnosed by an ophthalmologist, corticosteroid, an anti-inflammatory medication, was prescribed for the patient, which resulted in partial resolution of the lid swelling. However, he was lost to follow-up, and progressive enlargement of the lids was observed with the development of a right parotid mass. The visual acuity of the patient was classified as counting fingers, three feet bilaterally. A detailed examination was difficult owing to the obstructive nature of the masses. However, ocular structures appeared intact. An excisional biopsy with a reconstruction of bilateral upper lids was performed. Histopathologic findings revealed a lymphoproliferative lesion suggestive of Kimura disease (KD). The patient was subsequently referred to rheumatology for management, where they started a regimen of oral steroids and antihistamines.
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Affiliation(s)
| | - Fatima G Regala
- Department of Health Eye Center, East Avenue Medical Center, Quezon City, Metro Manila, Philippines
| | - Charmaine Y Ang
- Department of Health Eye Center, East Avenue Medical Center, Quezon City, Metro Manila, Philippines
| | - Marco A Tumalad
- Department of Health Eye Center, East Avenue Medical Center, Quezon City, Metro Manila, Philippines
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4
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Angiolymphoid hyperplasia with eosinophilia: a case series and literature review. Int Ophthalmol 2023:10.1007/s10792-023-02644-y. [PMID: 36869976 DOI: 10.1007/s10792-023-02644-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: 12/01/2022] [Accepted: 02/19/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE Angiolymphoid hyperplasia with eosinophilia is an uncommon chronic inflammatory condition of unknown etiology. Orbital and adnexal involvement findings are variable and often nonspecific. METHODS AND RESULT We report six patients with angiolymphoid hyperplasia of the orbit, their clinical and histopathological characteristics, and a review of previously published literature with this diagnosis between 1980 and 2021. CONCLUSION ALHE has definite histopathologic features but inconclusive radiological studies. The ophthalmologic findings of this entity overlap significantly with other similar variants and may be thought as equivalent lesions.
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5
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Danesh K, Cohen LM, Liu Y, Karlin JN, Rootman DB. Systemic eosinophilic disease presenting as dacryoadenitis. Orbit 2023; 42:107-111. [PMID: 34514933 DOI: 10.1080/01676830.2021.1973514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Eosinophilic disease with orbital involvement is rare. We present two patients with dacryoadenitis associated with local and systemic eosinophilia. A 32-year-old man presented with episodic dacryoadenitis, lower respiratory inflammation and peripheral eosinophilia. Lung and lacrimal gland biopsies demonstrated eosinophilic infiltrate without granuloma, necrosis, or vasculitis. He improved with oral corticosteroids and Mepolizumab, an IL-5 inhibitor. The second case involved a 33-year-old man who similarly presented with episodic dacryoadenitis, pulmonary inflammation and pain/swelling in the hands and feet. Lacrimal gland biopsy demonstrated a predominantly eosinophilic infiltrate without granuloma or vasculitis. Symptoms improved with oral corticosteroids. Although neither patient was provided a definitive diagnosis, both were determined to have an eosinophilic condition on the spectrum of eosinophilic asthma or eosinophilic granulomatosis with polyangiitis.
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Affiliation(s)
- Kayla Danesh
- University of California Los Angeles, Los Angeles, California, USA
| | - Liza M Cohen
- Division of Orbital and Ophthalmic Plastic Surgery, Doheny and Stein Eye Institutes, University of California, Los Angeles, Los Angeles, California, USA
| | - Yan Liu
- Department of Pathology and Human Anatomy, Loma Linda University Health, Loma Linda, California, USA
| | - Justin N Karlin
- Division of Orbital and Ophthalmic Plastic Surgery, Doheny and Stein Eye Institutes, University of California, Los Angeles, Los Angeles, California, USA
| | - Daniel B Rootman
- Division of Orbital and Ophthalmic Plastic Surgery, Doheny and Stein Eye Institutes, University of California, Los Angeles, Los Angeles, California, USA
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Han MM, Dermarkarian CR, Del Valle Estopinal MD, Tao JP. Kimura Disease of the Periorbita and Earlobe in a 15-Year-Old Male: A Case Report and Review of the Literature. Ophthalmic Plast Reconstr Surg 2023; 39:26-33. [PMID: 35699221 DOI: 10.1097/iop.0000000000002221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE The authors describe a case of Kimura disease (KD) affecting the lacrimal gland, the ipsilateral periorbita, and the contralateral earlobe. The authors also review the literature for characteristics and outcomes of KD affecting the periorbita or earlobe. METHODS The authors review retrospectively a single chart and abstract data from the English language literature. RESULTS A 15-year-old Samoan male presented with a left upper eyelid mass and later the contralateral earlobe and ipsilateral periorbita. Surgical resection was partially effective and normal vision and eye motility were maintained. Histopathology was consistent with KD. Thirty-seven cases of periorbital KD were identified in the literature. The average age of patients with periorbital KD was 31.9 years (standard deviation: 17.8 years), with 81.1% (30/37) of patients being male and 69.4% (25/36) Asian. Over half of periorbital KD patients had lacrimal gland involvement (51.3%; 19/37). Fifteen patients were initially treated with surgery; 3 (20%) had recurrence of the disease. Another 15 patients were initially treated with corticosteroids; 12 (80%) had recurrence of the disease. Ophthalmologic data, when reported, demonstrated that, most patients had no visual (77.8%; 14/18 patients) or motility disturbances (82.4%; 14/17 patients) but most had proptosis 71.4% (10/14). Only 4 cases of earlobe involvement in KD were identified, all in women. CONCLUSIONS In the literature, orbital KD was rare but often affected the lacrimal gland and caused proptosis, commonly in young adult Asian males. Vision and extraocular motility were usually normal. Earlobe involvement was very rare. This unique case of KD that affected the orbit and contralateral earlobe corroborates the prior literature that KD is prone to recurrence but may not adversely affect vision or extraocular motility.
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7
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Atypical Presentation of Kimura’s Disease in a Male Patient: A Case Report and Review of Literature. Case Rep Med 2022; 2022:5103547. [DOI: 10.1155/2022/5103547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/21/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022] Open
Abstract
Kimura’s disease (KD) is a rare chronic inflammatory condition of unknown aetiology. It is a benign disease that might mimic a neoplastic process. It primarily affects the head and neck region, presenting as deep subcutaneous masses, and is often accompanied by triad regional lymphadenopathy, salivary gland involvement, and high serum immunoglobulin E (IgE) levels. Here, we report the second documented case of KD in Palestine diagnosed in a 28-year-old male patient who presented with lymphadenopathy and increased serum immunoglobulin E and G (IgE and IgG) associated with intermittent abdominal pain, generalised fatigue, hepatomegaly, cardiomyopathy, reactive airway disease, peripheral vasculopathy, peripheral neuropathy, and focal segmental glomerulosclerosis. The patient was managed with steroids and an immunosuppressant (Azathioprine) with a moderate response for two years. In 2021, treatment with Mycophenolate Mofetil was initiated, which was more effective than Azathioprine.
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8
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Tsai YE, Chen YH, Liu T, Chien KH, Hsu CK. Optic neuropathy caused by orbital Kimura disease: A rare case report. Medicine (Baltimore) 2022; 101:e30750. [PMID: 36123864 PMCID: PMC9478222 DOI: 10.1097/md.0000000000030750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
RATIONALE Kimura disease (KD) is a rare, chronic inflammatory disease characterized by painless subcutaneous nodules predominantly located in the head and neck regions. Orbital KD, which intrudes into the intraconal space and results in compressive optic neuropathy, is rare and has not been previously reported. PATIENT CONCERNS A 68-year-old man presented with blurred vision and progressive proptosis in the left eye that had been present for 2 years. DIAGNOSIS Magnetic resonance imaging of the brain revealed soft tissue lesions with contrast enhancement and restricted diffusion involving the bilateral eyelids, orbits, and intraconal region; those on the left side were more prominent than those on the right side. The lesion encased the left optic nerve. Laboratory test results revealed elevated serum immunoglobulin E level and peripheral eosinophilia. An orbital mass biopsy demonstrated hyperplastic lymphoid follicles with germinal centers in the subcutaneous area and abundant mononuclear and binuclear eosinophils infiltrating the interfollicular area. A pathological diagnosis of KD was made based on the blood test results. INTERVENTIONS Orbital decompression and debulking surgery of the orbital tumor in the left eye were performed to treat the compressive optic neuropathy. OUTCOMES After systemic oral steroid and immunosuppressive agent therapies, the patient's visual acuity in the left eye improved, and the KD activity was stable. CONCLUSIONS We present a rare case of orbital KD-associated optic neuropathy, wherein early diagnosis and treatment preserved the patient's vision. This complication should be considered in patients with a history of compressive optic neuropathy during the differential diagnosis.
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Affiliation(s)
- Yung-En Tsai
- Department of Ophthalmology, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tung Liu
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ke-Hung Chien
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Kang Hsu
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Ophthalmology, Tri-Service General Hospital Songshan branch, Taipe, Taiwan
- *Correspondence: Chih-Kang Hsu, Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Chenggong Road, Neihu District, Taipei City, 114, Taiwan (e-mail: )
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9
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Bilateral Dacryoadenitis and Central Nervous System Involvement in a Child With Kimura Disease. Ophthalmic Plast Reconstr Surg 2022; 38:e106-e108. [DOI: 10.1097/iop.0000000000002150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Agrawal S, Sen S, Sabu S, Modaboyina S, Bajaj MS, Das D. Bilateral orbital Kimura's disease: A case report and brief review of literature. Indian J Ophthalmol 2022; 70:2737-2738. [PMID: 35791229 PMCID: PMC9426089 DOI: 10.4103/ijo.ijo_2648_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sahil Agrawal
- Oculoplasty & Paediatric Ophthalmology Services; Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Seema Sen
- Department of Ocular Pathology; Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Shilpa Sabu
- Oculoplasty & Paediatric Ophthalmology Services; Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Sujeeth Modaboyina
- Oculoplasty & Paediatric Ophthalmology Services; Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Mandeep Singh Bajaj
- Oculoplasty & Paediatric Ophthalmology Services; Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Deepsekhar Das
- Oculoplasty & Paediatric Ophthalmology Services; Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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11
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Alshaibani AK, Al-Mulla AH, Mohammed MA, Alhamoud M, Al-Hassan SA. Isolated Kimura Disease Presenting as a Brow Mass in a Saudi Male: A Rare Case Report. Cureus 2022; 14:e23000. [PMID: 35415044 PMCID: PMC8993031 DOI: 10.7759/cureus.23000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 11/05/2022] Open
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12
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Yadav S, Patil S, Puntambekar A, Deshpande R. Kimura's disease involving the conjunctiva. JOURNAL OF CLINICAL OPHTHALMOLOGY AND RESEARCH 2022. [DOI: 10.4103/jcor.jcor_104_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Matchin AA, Matts EG. [Kimura's disease. (Clinical case study)]. STOMATOLOGIIA 2022; 101:79-84. [PMID: 36562372 DOI: 10.17116/stomat202210106179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The author presents his own observation of a patient with Kimura's disease (CD), which is a rather rare chronic inflammatory disease of soft tissues. The results of clinical examination and surgical treatment of this disease are presented. It is emphasized that for the diagnosis of CD, first of all, an excision biopsy of the lesion is necessary, as well as the presence of eosinophilia in the patient, an increased level of immunoglobulin E (IgE) in peripheral blood, an increase in regional lymph nodes.
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Affiliation(s)
- A A Matchin
- Orenburg State Medical University, Orenburg, Russia
| | - E G Matts
- Orenburg State Medical University, Orenburg, Russia
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14
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Myositis of an Extraocular Muscle, a Possible Drug Reaction: Histopathologic and Immunopathologic Analysis. Ophthalmic Plast Reconstr Surg 2021; 37:e141-e143. [PMID: 33587420 DOI: 10.1097/iop.0000000000001923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 58-year-old man presented with left-sided orbital inflammation, including chemosis and a lateral rectus abduction defect. Initially presumed to represent cellulitis, the condition responded poorly to oral and intravenous antibiotics. CT showed the epicenter of an infiltrate to involve the lateral rectus. The patient improved dramatically when oral prednisone was added. Lateral rectus biopsy displayed intramuscular polyclonal lymphoid infiltrates, rich with eosinophils. Complete resolution of the inflammatory process was confirmed by a follow-up CT. The presumptive diagnosis was idiopathic orbital myositis, an uncommon condition of unknown etiology. However, the patient had taken rosuvastatin, which has been rarely associated with diplopia and ophthalmoplegia, raising the question of whether this case was truly idiopathic.
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15
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Sugimoto K, Enya T, Morimoto Y, Oshima R, Miyazaki K, Okada M. Kimura's disease with recurrent bilateral lacrimal gland involvement in a male Japanese child successfully treated with cyclosporine A. Allergy Asthma Clin Immunol 2021; 17:48. [PMID: 34001253 PMCID: PMC8130254 DOI: 10.1186/s13223-021-00549-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/30/2021] [Indexed: 12/03/2022] Open
Abstract
Background Kimura’s disease (KD) is a rare chronic inflammatory disease of unknown etiology. Clinically, KD is characterized by nodular subcutaneous masses, that are typically localized to the neck and head. Involvement of the lacrimal glands and limbs is uncommon and seldom reported. Case presentation We report a case of a 4-year-old Japanese boy presenting with bilateral upper eyelid swelling with nodular subcutaneous lesions and peripheral eosinophilia. Based on clinical, histopathological, and laboratory findings, the patient was diagnosed with KD. An itchy subcutaneous mass on the left arm developed at the age of 14 years. Treatment with steroids was effective. However, as the steroids were tapered after the patient developed side effects, the masses relapsed within a few months. Treatment with cyclosporine A was then initiated, which led to an improvement of clinical features and serial levels of cytokines. Conclusions We report a rare case of KD with a peculiar clinical presentation. The patient responded well to treatment with cyclosporine A.
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Affiliation(s)
- Keisuke Sugimoto
- Department of Pediatrics, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osakasayama, Osaka, 589-8511, Japan.
| | - Takuji Enya
- Department of Pediatrics, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osakasayama, Osaka, 589-8511, Japan
| | - Yuichi Morimoto
- Department of Pediatrics, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osakasayama, Osaka, 589-8511, Japan
| | - Rina Oshima
- Department of Pediatrics, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osakasayama, Osaka, 589-8511, Japan
| | - Kohei Miyazaki
- Department of Pediatrics, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osakasayama, Osaka, 589-8511, Japan
| | - Mitsuru Okada
- Department of Pediatrics, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osakasayama, Osaka, 589-8511, Japan
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Audelan T, Jamart C, Héron E, Keilani C, Meney J, Sahel JA, Pâques M, Boumendil J. [Kimura's disease involving the lacrimal gland: Case report]. J Fr Ophtalmol 2021; 44:e423-e427. [PMID: 33832753 DOI: 10.1016/j.jfo.2020.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 10/21/2022]
Affiliation(s)
- T Audelan
- Service d'ophtalmologie IV, Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
| | - C Jamart
- Service de médecine interne, Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - E Héron
- Service de médecine interne, Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - C Keilani
- Service d'ophtalmologie IV, Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - J Meney
- Service d'ophtalmologie IV, Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - J-A Sahel
- Service d'ophtalmologie IV, Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - M Pâques
- Service d'ophtalmologie IV, Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - J Boumendil
- Service d'ophtalmologie IV, Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
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17
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Chakraborti C, Saha AK, Bhattacharjee A, Lakra R. Kimura's disease involving bilateral lacrimal glands and extraocular muscles along with ipsilateral face: A unique case report. Indian J Ophthalmol 2020; 67:2107-2109. [PMID: 31755477 PMCID: PMC6896523 DOI: 10.4103/ijo.ijo_810_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 23 year female presented with bilateral recurrent swelling of eyelids along with ptosis and proptosis for last 3 years. She also had swellings over the right cheek, parotid gland, and retro auricular area along with regional lymphadenopathy. Systemic laboratory workup revealed raised serum IgE and a high peripheral eosinophil count. Computed tomography and magnetic resonance imaging showed bilateral enlargement of extraocular muscles, lacrimal glands, and ipsilateral parotid gland. Excision biopsy of the retro-auricular lymph node was suggestive of Kimura's disease (KD). The patient responded well to systemic corticosteroid. KD rarely affects orbit, but it should be included in the differential diagnosis of inflammatory diseases of the orbit. To our knowledge, this is the first reported case of KD from India involving the orbit, lacrimal gland, extraocular muscles, parotid gland and buccal area.
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Affiliation(s)
- Chandana Chakraborti
- Department of Ophthalmology, North Bengal Medical College, Darjeeling, West Bengal, India
| | - Ajoy Kumar Saha
- Department of Ophthalmology, North Bengal Medical College, Darjeeling, West Bengal, India
| | - Ankita Bhattacharjee
- Department of Ophthalmology, North Bengal Medical College, Darjeeling, West Bengal, India
| | - Rupanjili Lakra
- Department of Ophthalmology, North Bengal Medical College, Darjeeling, West Bengal, India
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18
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Stiefel HC, Ng JD, Wilson DJ, Albert DM. Orbital Cellular Epithelioid Hemangioma. Ocul Oncol Pathol 2019; 5:424-431. [PMID: 31768366 PMCID: PMC6873054 DOI: 10.1159/000496207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/11/2018] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To report a case of orbital cellular epithelioid hemangioma (EH) in which FOSB and CAMTA1 immunostains were used to detect a cytogenetic rearrangement as an adjunctive tool in diagnosis. METHODS Case report. RESULTS A patient with a history of prior ligation of a presumed orbital varix presented with recurrent proptosis. Imaging revealed a highly vascular right orbital mass. Microscopic examination revealed a circumscribed neoplasm composed of plump epithelioid endothelial cells with copious mildly eosinophilic cytoplasm and relatively uniform vesicular nuclei. To aid in diagnosis, immunostains for FOSB and CAMTA1 were performed to detect corresponding cytogenetic rearrangements. The presence of multifocal nuclear positivity for FOSB, indicating FOSB genetic rearrangement, and negativity for CAMTA1 were considered reassuring features against a diagnosis of a malignant epithelioid hemangioendothelioma (EHE), supporting a diagnosis of benign cellular EH. CONCLUSIONS This case report demonstrates that the use of immunohistochemical stains to detect cytogenetic rearrangements may aid in the distinction between benign EH and malignant EHE. It also reminds providers of the clinical and histopathologic features of this lesion, which occurs rarely in the orbit, and helps clarify the evolving nomenclature surrounding epithelioid hemangioma.
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Affiliation(s)
- Hillary C Stiefel
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - John D Ng
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - David J Wilson
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Daniel M Albert
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
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Oka N, Nishimura S, Tanaka H, Hashimoto K, Kakinoki R, Akagi M. Angiolymphoid hyperplasia with eosinophilia in a hand treated with a reverse digital island flap and artificial skin: a case report. J Med Case Rep 2019; 13:87. [PMID: 30914066 PMCID: PMC6436222 DOI: 10.1186/s13256-019-2021-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Angiolymphoid hyperplasia with eosinophilia is a rare nodular skin tumor characterized by eosinophilic invasion and vascular proliferation. Previous reports suggested that irritation and inflammation are the causative factors of this disease. Most cases of angiolymphoid hyperplasia with eosinophilia occur around the auricle, forehead, and scalp; the hand is rarely affected. Moreover, the tumor seldom presents as multiple nodules. CASE PRESENTATION A 67-year-old Japanese woman presented with a complaint of skin masses on her left thumb and index finger, which had gradually grown in size over the past few months. A biopsy was performed confirming a diagnosis of angiolymphoid hyperplasia with eosinophilia. The aponeurosis on her index finger was resected and tissue was reconstructed using a reverse palmar digital island flap harvested from the base of her index finger. The thumb lesion was also resected and covered with collagen-based artificial skin. Gradual progression of skin epithelialization followed by healing was noted 2 months after the surgery. CONCLUSION Angiolymphoid hyperplasia with eosinophilia is a rare tumor; it is seldom seen in the hands. It is generally treated by surgical resection. It is important to resect a sufficiently large area of the tissue due to the possibility of relapse in some cases. Furthermore, appropriate reconstruction is mandatory after wide margin tumor resection.
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Affiliation(s)
- Naohiro Oka
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Shunji Nishimura
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Hiroki Tanaka
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Kazuhiko Hashimoto
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Ryosuke Kakinoki
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Masao Akagi
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
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Li X, Wang J, Li H, Zhang M. Misdiagnosed recurrent multiple Kimura's disease: A case report and review of the literature. Mol Clin Oncol 2018; 10:352-356. [PMID: 30847173 PMCID: PMC6388464 DOI: 10.3892/mco.2018.1793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/07/2018] [Indexed: 11/05/2022] Open
Abstract
Kimura's disease (KD) is a rare condition, with only a few cases reported to date, mainly in Asian patients. We herein present the case of a 48-year-old man with KD who presented with recurrent masses in the right parotid gland and neck region over a 15-year period. The masses were not accompanied by pain, or significant functional or neurosensory dysfunction. The results of the laboratory tests revealed an increased eosinophil count and markedly elevated serum IgE levels. On magnetic resonance imaging examination, a widespread abnormal signal was detected in the area of the lesions; the contrast-enhanced scan revealed inhomogeneous enhancement, with partial involvement of the sternocleidomastoid muscle and the parotid gland. The patient underwent surgical resection of the right parotid and neck masses, and the postoperative pathological examination revealed eosinophilic hyperplastic lymphogranuloma, also referred to as KD. This presented case and review of the relevant literature aim to improve our understanding of KD in order to increase the accuracy of diagnosis, reduce the misdiagnosis rate and ensure proper treatment of this rare disease.
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Affiliation(s)
- Xuesheng Li
- Department of Prosthodontics, Hainan Stomatological Hospital, Haikou, Hainan 570105, P.R. China
| | - Jing Wang
- Department of Stomatology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
| | - Hongbo Li
- Department of Stomatology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
| | - Ming Zhang
- Department of Stomatology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
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Matsuo T, Tanaka T, Kinomura M. Nephrotic syndrome during the tapering of oral steroids after pathological diagnosis of Kimura disease from a lacrimal gland mass: case report and review of 10 Japanese patients. J Clin Exp Hematop 2018; 57:147-152. [PMID: 29279552 DOI: 10.3960/jslrt.17028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A 42-year-old man with eosinophilia and high serum immunoglobulin E (IgE) developed a lacrimal gland mass on the left side. Excisional biopsy revealed hyperplasia of lymphoid follicles, and infiltration with lymphocytes and eosinophils around lacrimal gland acini, leading to the pathological diagnosis of Kimura disease. IgE-positive cells were mainly found along follicular dendritic cells, and a small number of IgG4-positive cells was present. One month after oral prednisolone was started at 40 mg daily and tapered to 10 mg daily, he developed lower leg edema on both sides and marked proteinuria (10.8 g/day). Renal biopsy showed no glomerular abnormalities, no immunoglobulin deposition, and no tubulointerstitial infiltration with eosinophils, leading to the diagnosis of minimal change nephrotic syndrome. Proteinuria subsided in response to an increased dose of prednisolone to 30 mg daily. Proteinuria relapsed three times in the following 5 years when oral prednisolone was tapered. In conclusion, Kimura disease manifested as an orbital mass and did not relapse. However, nephrotic syndrome relapsed frequently with background eosinophilia and high serum IgE. This study reviewed the clinical features of 10 Japanese patients with Kimura disease associated with proteinuria.
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Affiliation(s)
- Toshihiko Matsuo
- Department of Ophthalmology, Okayama University Hospital and Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Takehiro Tanaka
- Department of Pathology Okayama University Hospital and Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Masaru Kinomura
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Hospital and Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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Mukherjee B, Kadaskar J, Priyadarshini O, Krishnakumar S, Biswas J. Angiolymphoid Hyperplasia with Eosinophilia of the Orbit and Adnexa. Ocul Oncol Pathol 2015; 2:40-7. [PMID: 27171790 DOI: 10.1159/000433545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 05/12/2015] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare disorder presenting with solitary or multiple nodules in the dermis or subcutaneous tissues. ALHE shares clinical as well as histopathological characteristics with Kimura disease (KD), but they have been considered to be two distinct entities based on their histological features. Orbital and adnexal involvement in ALHE is rare. The published literature is limited to few case reports featuring single cases. METHODS We report a series of 5 cases of ALHE presenting with diverse clinical features seen at a tertiary referral care centre in India. We also review the published literature with a special emphasis on the treatment modalities for orbital and adnexal ALHE. RESULTS Three patients of this series presented with orbital involvement, while the remaining 2 had involvement of the eyelid. Three patients underwent incisional and/or excisional biopsy, whereas 2 were managed conservatively. There were no recurrences seen on follow-up. CONCLUSIONS ALHE can rarely involve the orbit and adnexa. There is no consensus on the best modality of management of this rare entity. ALHE and KD have often been considered variations of the same disease, but it is important to differentiate between the two entities for optimal patient management.
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Affiliation(s)
- Bipasha Mukherjee
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Chennai, India
| | - Jayant Kadaskar
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Chennai, India
| | | | | | - Jyotirmay Biswas
- Ocular Pathology, Sankara Nethralaya Medical Research Foundation, Chennai, India
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Monzen Y, Kiya K, Nishisaka T. Kimura's Disease of the Orbit Successfully Treated with Radiotherapy Alone: A Case Report. Case Rep Ophthalmol 2014; 5:87-91. [PMID: 24748872 PMCID: PMC3985780 DOI: 10.1159/000360789] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We performed radiotherapy in a 28-year-old patient with Kimura's disease of the orbit. Irradiation with 21.6 Gy was administered to the tumor bed with a single dose of 1.8 Gy in 5 weekly fractions delivered via a high-energy linear accelerator (6-MV X-ray). Complete remission of the tumor and improvements in the neurological findings were achieved. Neither tumor regrowth nor late complications were detected up to 84 months after radiotherapy. Radiotherapy is an effective treatment for Kimura's disease of the orbit.
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Affiliation(s)
- Yoshio Monzen
- Department of Radiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Katsuzo Kiya
- Department of Neurosurgery, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Takashi Nishisaka
- Department of Pathology, Hiroshima Prefectural Hospital, Hiroshima, Japan
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Krema H, El-Bolkainy N. A stepwise multimodality treatment of diffuse angiolymphoid hyperplasia of the orbit. Orbit 2013; 33:75-7. [PMID: 24195724 DOI: 10.3109/01676830.2013.851254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The definite treatment of angiolymphoid hyperplasia is debatable. We report the case of a middle-aged man with an extensive angiolymphoid hyperplasia of the orbit that has been recalcitrant to multiple single-line treatments for 9 years. His previous treatment included several short courses of full-dose systemic steroids, debulking surgeries, and orbital radiotherapy. A stepwise multimodality treatment approach in this case could achieve a lasting satisfactory functional and cosmetic outcome.
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Affiliation(s)
- Hatem Krema
- Department of Ocular Oncology, Princess Margaret Hospital/University Health Network, University of Toronto , Toronto, ON , Canada
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Praeger AJ, Tsui A, Hardy TG. Kimura disease: rare cause of a slowly progressive orbital mass. Clin Exp Ophthalmol 2013; 42:385-7. [PMID: 24119195 DOI: 10.1111/ceo.12242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 08/29/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Adrian J Praeger
- Department of Ophthalmology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Kim WJ, Chung MJ, You IC. Kimura disease involving a caruncle. KOREAN JOURNAL OF OPHTHALMOLOGY 2013; 27:137-40. [PMID: 23543681 PMCID: PMC3596619 DOI: 10.3341/kjo.2013.27.2.137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 09/18/2011] [Indexed: 11/23/2022] Open
Abstract
A 35-year-old woman presented with history of a painless, slow-growing nodule in a left eye caruncle over the last 2 months. The visual acuity was 20 / 20 and the ocular movements were in the normal range. The venereal disease research laboratory test, erythrocyte sedimentation rate, serum angiotensin converting enzyme level, and chest radiograph were all normal. An excisional biopsy was done to confirm the diagnosis. A 1.3 × 0.5 × 0.3 cm sized nodule was extracted and sent for histopathologic examination. Hematoxylin-eosin staining showed follicular hyperplasia with perifollicular fibrosis, an eosinophil infiltrate, and proliferation of capillary vessels. The capillaries were lined by normal-appearing, flat, spindle-shaped endothelial cells. On the basis of these histopathologic findings, the diagnosis of Kimura disease in a caruncle was established. This is the first report describing Kimura disease localized to a caruncle. Kimura disease should be suspected and included in the differential diagnosis of a caruncular mass lesion.
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Affiliation(s)
- Woo Jin Kim
- Department of Ophthalmology, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
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Angiolymphoid hyperplasia with eosinophilia of the eyelid and orbit: the Western cousin of Kimura’s disease? Int Ophthalmol 2013; 34:107-10. [DOI: 10.1007/s10792-013-9741-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 02/06/2013] [Indexed: 10/27/2022]
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Abstract
UNLABELLED ABSTRACT Introduction: Epithelioid hemangioma (EH) is a benign abnormal proliferation of endothelial cells usually arising in the head and neck region and presenting clinically as raised cutaneous lesions. EH rarely involves the orbit and has not been reported to occur bilaterally. CASE A healthy 38 year old female developed sequential proptosis of each orbit over the course of several months. The patient underwent excisional biopsy confirming the diagnosis of EH in each orbit. She was treated with a course of high dose steroids and has been stable at 13 months following the most recent excision. CONCLUSION This is the first reported case of bilateral EH.
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Affiliation(s)
- Brian Alder
- Department of Ophthalmology, Duke University Medical Center, Durham, NC 27710, USA
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31
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Shevchenko L, Aaberg T, Grossniklaus HE. Conjunctival angiolymphoid hyperplasia with eosinophilia in a child. J Pediatr Ophthalmol Strabismus 2012. [PMID: 23205877 DOI: 10.3928/01913913-20121127-04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Angiolymphoid hyperplasia with eosinophilia is a rare benign vascular proliferation with lymphocytic and eosinophilic infiltrate. Angiolymphoid hyperplasia with eosinophilia presents as single or multiple dome-shaped papules or plaques involving the dermis and subcutaneous tissues of the head and neck region. Conjunctival angiolymphoid hyperplasia with eosinophilia is rare, with only two previous case reports.
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Affiliation(s)
- Liliya Shevchenko
- Michigan State University and Metro Health Hospital, Grand Rapids, MI, USA.
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32
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Kahana A, Lee BJ, Flint A, Elner VM. Periocular epithelioid hemangioma: response to bevacizumab and vascular pathogenesis. ACTA ACUST UNITED AC 2012; 130:1209-12. [PMID: 22965602 DOI: 10.1001/archophthalmol.2012.572] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Alon Kahana
- Department of Ophthalmology, University of Michigan, Ann Arbor, MI 48105, USA
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Baker MS, Avery RB, Johnson CR, Allen RC. Methotrexate as an alternative treatment for orbital angiolymphoid hyperplasia with eosinophilia. Orbit 2012; 31:324-326. [PMID: 23030406 DOI: 10.3109/01676830.2011.584932] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon, benign disorder that presents as solitary or multiple nodules in the dermis or subcutaneous tissue. Orbital ALHE has been reported on occasion. We report a case of orbital ALHE which was refractory to systemic steroids but effectively treated with low-dose subcutaneous methotrexate. To our knowledge, this is the first reported case of methotrexate as a successful treatment for refractory ALHE.
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Affiliation(s)
- Meredith S Baker
- Department of Ophthalmology and Visual Sciences University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Tauro DP, Kumar KK, Shibani S, Hallikeri K. Unusual presentation of Kimura's disease involving the parotid gland in an Indian male: a case report and review of literature. J Oral Biol Craniofac Res 2012; 2:50-2. [PMID: 25756033 PMCID: PMC3942153 DOI: 10.1016/s2212-4268(12)60012-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Kimura's disease (KD) is a rare chronic inflammatory disorder that involves the subcutaneous tissues and occurs predominantly in the head and neck region, frequently associated with regional lymphadenopathy or salivary gland involvement. Although, not an uncommon condition in the Asian countries, it is quite rare among the occidental civilization and in the western countries is more commonly diagnosed among Asian migrants. Kimura's disease is sometimes confused with angiolymphoid hyperplasia with eosinophilia, which occurs in the superficial skin of the head and neck region. The classical features of angiolymphoid hyperplasia with eosinophilia are characterized by a triad of painless subcutaneous masses in the head and neck region, blood and tissue eosinophilia, and markedly elevated immunoglobulin E (IgE) levels. Here, we report a case of a 33-year-old Indian male with KD who presented with unilateral nodular swelling in the right parotid region. The diagnosis was based on characteristic histopathologic findings in conjunction with peripheral eosinophilia and elevated serum IgE levels.
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Affiliation(s)
- David P Tauro
- Professor and Consultant Surgeon, The Taulins Clinic, Center for Cranio Maxillofacial Plastic and Reconstructive Surgery, Bengaluru, Karnataka, India
| | - K Kiran Kumar
- Reader, Department of Oral and Maxillofacial Pathology, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - S Shibani
- Senior Lecturer, Department of Oral Pathology, MR Ambedkar Dental College, Bengaluru, Karnataka, India
| | - Kaveri Hallikeri
- Professor, Department of Oral and Maxillofacial Pathology, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India
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Matsunaga Y, Usui Y, Kasai K, Sakurai Y, Goto H. Refractory eosinophilic granulation tissue of the palpebral conjunctiva. Jpn J Ophthalmol 2009; 53:648-650. [PMID: 20020246 DOI: 10.1007/s10384-009-0720-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Accepted: 04/17/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Yoshimichi Matsunaga
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku, Tokyo, 160-0023, Japan.
| | - Yoshihiko Usui
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku, Tokyo, 160-0023, Japan
| | - Kenichiro Kasai
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku, Tokyo, 160-0023, Japan
| | - Yu Sakurai
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku, Tokyo, 160-0023, Japan
| | - Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku, Tokyo, 160-0023, Japan
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Nassr MA, Morris CL, Netland PA, Karcioglu ZA. Intraocular pressure change in orbital disease. Surv Ophthalmol 2009; 54:519-44. [PMID: 19682621 DOI: 10.1016/j.survophthal.2009.02.023] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 02/25/2009] [Indexed: 01/18/2023]
Abstract
Intraocular pressure change has been found concurrent with many orbital pathologies, particularly those involving proptosis. The objective of this review is to offer an inclusive classification of orbital disease-related intraocular pressure change, not only for oculoplastics and glaucoma specialists, but also for general ophthalmologists. Various orbital conditions associated with increased intraocular pressure and glaucoma are comprehensively summarized, and pathophysiology, clinical manifestations, and treatment options of these diseases are discussed. Graves disease, arterio-venous shunts, trauma, and orbital neoplasia, and other common conditions are discussed in detail; less frequent syndromes such as orbitocraniofacial deformities, phakomatoses, and mucopolysaccharidoses are included for the sake of comprehensiveness, but discussed less extensively.
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Affiliation(s)
- Mohamed A Nassr
- Hamilton Eye Institute, Health Sciences Center University of Tennessee, Memphis, Tennessee 38163, USA
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Lee JKS, Almousa R, Thamboo TP, Amrith S. Kimura disease of the eyelid in an Indian man. Clin Exp Ophthalmol 2009; 37:412-4. [DOI: 10.1111/j.1442-9071.2009.02049.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
INTRODUCTION Kimura's disease is a rare, chronic inflammatory disorder of unknown cause, mainly seen in young Asian men. To our knowledge it has not been reported previously in persons from the Balkan countries. CASE REPORT We presented a 15-year-old male with Kimura's disease manifested as chronic left neck mass. The diagnosis was based on the histopathological findings of the excised lesion. Peripheral blood eosinophilia and raised serum Immunoglobulin E (IgE) level supported the diagnosis. CONCLUSION The presented patient confirmed the fact that Kimura's disease could occur in different ethnic groups. Histopathological examination, should be performed prior to making the definitive diagnosis.
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Park JS, Jin W, Ryu KN, Won KY. Bilateral asymmetric superficial soft tissue masses with extensive involvement of both upper extremities: demonstration of Kimura's disease by US and MRI (2008: 12b). Eur Radiol 2009; 19:781-6. [PMID: 19194711 DOI: 10.1007/s00330-008-1059-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Accepted: 03/30/2008] [Indexed: 10/21/2022]
Abstract
Kimura's disease is known as a rare chronic inflammatory disease occurring mainly in the head and neck regions of Asian male patients. We present a case of Kimura's disease with extensive involvement of the bilateral upper extremities in a 20-year-old Korean man. Ultrasonography (US) and magnetic resonance imaging (MRI) demonstrated the presence of partially ill-defined, conglomerated soft tissue masses centered in the subcutaneous layer of both upper arms, with cranial extension along the cutaneous nerve in the right lesion. Medial epitrochlear, axillary and lower cervical lymphadenopathy accompanied the masses.
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Affiliation(s)
- Ji Seon Park
- Department of Radiology, Kyung Hee University Medical Center, Seoul, Korea.
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Sánchez-Acosta A, Moreno-Arredondo D, Rubio-Solornio RI, Rodríguez-Martínez HA, Rodríguez-Reyes AA. Angiolymphoid hyperplasia with eosinophilia of the lacrimal gland: a case report. Orbit 2008; 27:195-8. [PMID: 18569828 DOI: 10.1080/01676830701804099] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare clinicopathologic entity that has been the subject of considerable confusion and debate. ALHE shares both clinical and histopathologic features with Kimura disease (KD). Because of this overlap, ALHE and KD have been used synonymously in the Western medical literature, as they were thought to represent variations of the same disease. Some pathologic reports have called for distinguishing ALHE and KD as two separate nosological entities, based on their clinical, laboratory, and especially histopathologic findings. ALHE commonly affects women in the third and fourth decades, with head and neck involvement. ALHE has been described rarely in the orbit, eyelids, and lacrimal gland. We report a case of ALHE involving the left lacrimal gland in a 40-year-old Mexican woman. Because ALHE can cause proptosis, lid swelling, ocular dysmotility, or a palpable mass, it should be considered in the differential diagnosis of orbital lesions occurring in adults.
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Affiliation(s)
- Antonio Sánchez-Acosta
- Oculoplastic Service, Association to Prevent Blindness in Mexico, Dr. Luis Sánchez Bulnes Hospital, Mexico City, Mexico.
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Simultaneous Presentation of Kimura Disease and Angiolymphoid Hyperplasia With Eosinophilia. Ophthalmic Plast Reconstr Surg 2008; 24:310-1. [DOI: 10.1097/iop.0b013e31817e9bba] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Angiolymphoid Hyperplasia With Eosinophilia of the Eyelid With Spontaneous Regression. Ophthalmic Plast Reconstr Surg 2008; 24:308-10. [DOI: 10.1097/iop.0b013e31817d8765] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Huang M, Lloyd WC, O'Hara M. Angiolymphoid hyperplasia with eosinophilia: an unusual presentation in a child. J AAPOS 2008; 12:302-4. [PMID: 18356092 DOI: 10.1016/j.jaapos.2007.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Revised: 11/27/2007] [Accepted: 12/31/2007] [Indexed: 11/28/2022]
Abstract
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign proliferation that usually presents as pink to brown dermal nodules in the head and neck region of young adults. We present a biopsy-proven case of ALHE arising in the conjunctiva of an 11-year-old girl. The lesion was treated with excision. After 2 years there has been no recurrence.
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Affiliation(s)
- Margaret Huang
- Department of Ophthalmology and Vision Science, University of California Davis Medical Center, Sacramento, California 95817, USA
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Fernandes BF, Al-Mujaini A, Petrogiannis-Haliotis T, Al-Kandari A, Arthurs B, Burnier MN. Epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) of the orbit: a case report. J Med Case Rep 2007; 1:30. [PMID: 17592625 PMCID: PMC1913531 DOI: 10.1186/1752-1947-1-30] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Accepted: 06/25/2007] [Indexed: 11/23/2022] Open
Abstract
Background Angiolymphoid hyperplasia with eosinophilia (ALHE) and Kimura's Disease (KD) share many clinical and histopathological features. Although they were once considered different stages of the same disease, they are now known to represent separate entities. Recently, ALHE is being called epithelioid hemangioma (EH), a term that better describes the possible neoplastic nature of the entity. Case Presentation An eighteen year-old Asian female presented with a three-month history of fluctuating swelling and ptosis of the left upper eyelid. Computed tomography disclosed a distinct homogeneous lesion in the left superior orbit, molding to the globe and other orbital structures. At histopathological evaluation the lesion was composed of numerous blood vessels lined by plump endothelial cells with oval nuclei protruding into the lumen. Surrounding the vessels, there was a chronic inflammatory infiltrate with a large proportion of eosinophils. Based on clinical and histopathological findings, the diagnosis of EH was made. Conclusion Although exams like blood count, urinalysis and whole body scans can assist in the differential diagnosis, EH can be diagnosed and differentiated from KD on histopathological grounds. The presence of vascular hyperplasia with plump endothelial cells protruding into the lumen is the most important discriminator in establishing the diagnosis of EH. Such distinction is crucial for the patient because EH is not associated with any of the systemic manifestations present in KD.
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Affiliation(s)
- Bruno F Fernandes
- Department of Ophthalmology and Pathology. Henry C. Witelson Ocular Pathology Laboratory & Mcgill University Health Centre, Montreal, QC, Canada
- Department of Ophthalmology. Federal University of São Paulo, São Paulo, Brazil
| | - Abdullah Al-Mujaini
- Department of Ophthalmology Mcgill University Health Centre. Montreal, QC, Canada
| | | | - Abdullah Al-Kandari
- Department of Ophthalmology and Pathology. Henry C. Witelson Ocular Pathology Laboratory & Mcgill University Health Centre, Montreal, QC, Canada
| | - Bryan Arthurs
- Department of Ophthalmology Mcgill University Health Centre. Montreal, QC, Canada
| | - Miguel N Burnier
- Department of Ophthalmology and Pathology. Henry C. Witelson Ocular Pathology Laboratory & Mcgill University Health Centre, Montreal, QC, Canada
- Department of Ophthalmology. Federal University of São Paulo, São Paulo, Brazil
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Meningaud JP, Pitak-Arnnop P, Fouret P, Bertrand JC. Kimura’s Disease of the Parotid Region: Report of 2 Cases and Review of the Literature. J Oral Maxillofac Surg 2007; 65:134-40. [PMID: 17174779 DOI: 10.1016/j.joms.2005.10.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2005] [Accepted: 10/19/2005] [Indexed: 10/23/2022]
Affiliation(s)
- Jean-Paul Meningaud
- Department of Maxillofacial Surgery and Stomatology, Teaching Pitié-Salpêtrière Hospital, Paris, France.
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Brooks DR, Butnor KJ, Weinberg DA. Spontaneous Orbital and Periocular Hemorrhage in a Patient with Epithelioid Hemangioma. Ophthalmic Plast Reconstr Surg 2006; 22:487-9. [PMID: 17117114 DOI: 10.1097/01.iop.0000244516.83893.de] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Epithelioid hemangioma, or angiolymphoid hyperplasia with eosinophilia, is a benign vascular lesion that infrequently involves the orbit. We report a case of spontaneous orbital and periocular hemorrhage in a patient with epithelioid hemangioma of the orbit. Ophthalmic examination was accompanied by CT and MRI, followed by histopathologic diagnosis. The patient presented with headache, eyelid bruising, and double vision. Ophthalmic examination showed ecchymosis, proptosis, and limited extraocular movements of the affected eye. Imaging studies showed a cystic right orbital mass. Histologic examination showed plump endothelial cells accompanied by lymphocytes, plasma cells, and eosinophils. A diagnosis of epithelioid hemangioma was rendered. To our knowledge, this is the first reported case of spontaneous orbital and periocular hemorrhage associated with epithelioid hemangioma. Epithelioid hemangioma should be considered in the differential diagnosis for patients presenting with spontaneous orbital or periocular hemorrhage.
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Affiliation(s)
- Daniel R Brooks
- College of Medicine, University of Vermont College of Medicine, Burlington, Vermont, USA
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Prabhakaran VC, Sachdev A, Cheung D, Fletcher A, Brown LJR, Sampath R. Kimura Disease of the Eyelid: A Clinicopathologic Study With Electron Microscopic Observations. Ophthalmic Plast Reconstr Surg 2006; 22:495-8. [PMID: 17117118 DOI: 10.1097/01.iop.0000246604.56293.ed] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
A 70-year-old white man presented with a solitary eyelid nodule of 6 months' duration. Because lymphoma could not be excluded on the initial biopsy, the mass was completely excised. Histologic examination confirmed the diagnosis of Kimura disease, an uncommon chronic inflammatory condition. Peripheral eosinophilia was present. The patient did not have any other lesions of Kimura disease on follow-up examination. The clinical, radiologic, histologic, and electron microscopic findings of Kimura disease are discussed. To our knowledge, solitary involvement of the eyelid has not been reported previously. Kimura disease should be included in the differential diagnosis of an eyelid mass lesion.
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Ramchandani PL, Sabesan T, Hussein K. Angiolymphoid hyperplasia with eosinophilia masquerading as Kimura disease. Br J Oral Maxillofac Surg 2006; 43:249-52. [PMID: 15888362 DOI: 10.1016/j.bjoms.2004.11.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2004] [Indexed: 10/25/2022]
Abstract
Angiolymphoid hyperplasia with eosinophilia is a rare benign vasoproliferative disease of unknown cause, which can present as tumour-like nodules in the head and neck. We treated a patient who showed some of the features of Kimura disease (KD), which is an important differential diagnosis, because of the latter's association with renal disease.
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Affiliation(s)
- P L Ramchandani
- Maxillofacial Unit, Poole Hospital, Longfleet Road, Poole, Dorset BH15 2JB, UK.
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Acocella A, Catelani C, Nardi P. Angiolymphoid hyperplasia with eosinophilia: A case report of orbital involvement. J Oral Maxillofac Surg 2005; 63:140-4. [PMID: 15635569 DOI: 10.1016/j.joms.2004.04.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Alessandro Acocella
- Division of Maxillo-Facial Surgery, Department of Odontostomathology, Faculty of Medicine, University of Florence, Firenze, Italy.
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