Kimura's disease: upper limb involvement in a Pacific Island man

A rare disease in an atypical location-Kimura's Disease of the upper extremity

Kimura's disease is a rare chronic inflammatory disorder predominantly affecting young Asian male patients, occurring mainly in the head and neck regions. Kimura's disease of the upper extremity is extremely rare, and previous case reports in the literature show similar imaging characteristics with consistent location at the medial epitrochlear region, predominantly with unilateral involvement. We present the first reported case of Kimura's disease affecting the anterolateral aspect of the upper arm, sparing the medial epitrochlear region, illustrating that with typical MR appearance and serology, the involvement of this rare disease in an atypical location still warrants consideration of this diagnosis. There was also bilateral asymmetrical involvement in our patient, suggesting the possibility of a propensity for Kimura's disease affecting the upper extremities to have bilateral involvement, which may necessitate imaging of the clinically asymptomatic contralateral limb in these patients for early lesion identification and treatment.

Kimura's disease of the elbows

Kimura's disease rarely involves a location outside the head and neck. We report a case of Kimura's disease in a young Asian man involving both elbows. Magnetic resonance imaging showed a soft-tissue mass of irregularly infiltrative strands in the subcutaneous fat accompanied with medial epitrochlear lymphadenopathy. The MRI appearance is described and the entity is briefly reviewed.

Imaging findings of Kimura's disease in the soft tissue of the upper extremity

OBJECTIVE

The objective of our study was to describe the imaging findings of Kimura's disease in the soft tissue of the upper extremity.

CONCLUSION

Kimura's disease should be considered as a possible diagnosis when a partially or poorly defined subcutaneous mass of high signal intensity on T1- and T2-weighted images with homogeneous enhancement, surrounding subcutaneous edema, and internal flow voids is seen in the medial epitrochlear region in an Asian person, especially if accompanied by peripheral eosinophilia.