A pathological study on eosinophilic lymphfolliculoid granuloma (Kimura's disease)

Kimura's disease as a mimicker of cavernous hemangioma: A case report and literature review

Kimura's disease (KD) is an immune-mediated disorder which mainly affects Asian men. It appears as head and neck subcutaneous masses, with inflammatory infiltrate and elevated serum immunoglobulin E levels. The clinical presentation of KD resembles that of various diseases. Here, we report the case of a 30-year-old Filipino man with KD mimicking cavernous hemangioma who was treated by surgery. Careful survey for possible KD cases is crucial. Misdiagnoses are prone to futile interventions and unwanted effects. Surgery with adjuvant therapy is superior to other forms of KD treatment.

MRI evaluation of Kimura's disease with emphasis on diffusion weighted imaging and enhancement characteristics

Kimura's disease is a rare disease of the head and neck region affecting mainly the adult males in eastern countries. The parotid and periparotid subcutaneous regions are the most common sites in head and neck region. Coupled with peripheral eosinophilia and raised serum IgE levels as characteristic features on hemogram, a painless swelling in parotid and periparotid region is diagnostic of Kimura's disease. Magnetic resonance imaging (MRI) has been an important modality in evaluating lesions of the head and neck region. Recently, interest in the diffusion weighted imaging (DWI) and contrast enhanced MRI (CEMRI) imaging of lesions in Kimura's disease has been noted to characterize it and differentiate it from other pathologies. We describe a case a recurrent Kimura's disease of the periparotid region and its MRI features with special emphasis on its characteristics on DWI and contrast enhanced sequences.

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.

Kimura's disease (angiolymphoid hyperplasia with eosinophilia) associated with ulcerative colitis

We treated a 35-year-old Japanese woman who had Kimura's disease associated with ulcerative colitis. Kimura's disease is an uncommon chronic inflammatory disease considered to be of allergic origin based on the presence of eosinophilia and IgE hyperimmunoglobulinemia, and may be a manifestation of a systemic immunologic disturbance. Some immunological complications such as nephrotic syndrome have been reported in association with Kimura's disease, but the present case is the first associated with ulcerative colitis.

Angiolymphoid hyperplasia with eosinophilia: possible aetiological role for immunisation

Five young children (mean age 26.4 months) with angiolymphoid hyperplasia with eosinophilia (Kimura's disease) from either the upper arm or buttock were identified over 18 months. The unusual distribution of the lesions and the young age of the patients suggested a possible association with immunisation. The clinical and histopathological features in these cases were accordingly reviewed. The biopsy specimens showed the usual histological appearances of a prominent inflammatory component, fibrosis, and vascular proliferation associated with aggregates of eosinophils. The features were those of a reactive rather than neoplastic process. Immunohistochemical preparations showed positive staining of variable numbers of plasma cells with antibodies to IgG, IgM, IgA and IgE and a reticular staining of germinal centres with IgM and IgE antibodies. Immunisation histories obtained from the patients' general practitioners showed a remarkable correlation between the distribution of the lesions and the sites of injections and an aetiological role for immunisation in these cases seems likely.