Kimura's Disease in a Caucasian Female: A Very Rare Cause of Lymphadenopathy

Kimura's Disease: A Confounding Condition

Kimura disease (KD) is a chronic inflammatory lymphoproliferative disorder of unknown etiology and unsure pathogenesis. It primarily involves the head and neck region, presenting as an asymptomatic unilateral soft-tissue mass in the head and neck, frequently involving subcutaneous tissues, major salivary gland, lymph nodes. Peripheral blood eosinophilia, elevated serum immunoglobulin E (IgE) levels, and the microscopically lymphoid proliferation with eosinophilic infiltration are the characteristic features. We report a case of KD in a 22-year-old Indian male who presented with an asymptomatic parotid gland enlargement with lymphadenopathy. The clinical presentation was suggestive of the benign lesion but histopathology, as well as microscopic findings, allowed us to make a definitive diagnosis of KD. The patient was treated with steroids and antihistamine and showed no recurrence on follow-up.

Kimura disease: a rare cause of a recurrent cheek mass in a Jamaican man

Kimura disease (KD) is a chronic, inflammatory, benign disorder endemic to Asia that typically manifests as a triad of painless masses in the head and neck region, elevated eosinophils and serum immunoglobulin. It usually affects young men in their second and third decades of life and is rarely seen outside of the orient. This is a report of a case of KD in a young man of African descent who presented with a cheek mass. KD was not included in our differential diagnosis, and this report highlights the need to consider this entity, which can be easily missed due to its rarity in the Western world. There is no cure for the disease, and management includes medical and surgical modalities, but local recurrence or relapse is not uncommon.

Kimura's disease mimicking thoracic spine dumbbell neurogenic tumor: a case report and literature review

Background

Kimura’s disease is a rare, benign chronic inflammatory disease of unknown etiology that mostly affects Asians. The disease typically presents as subcutaneous masses in the head or neck region that are predominantly found in the preauricular and submandibular areas.

Case presentation

A 7-year-old boy presenting with paralysis of both lower extremities and a thoracic spine dumbbell mass was initially diagnosed with a neurogenic tumor, but the pathological and laboratory examinations confirmed the diagnosis of Kimura’s disease. The paralysis symptom disappeared rapidly, but the patient had developed a recurrent mass in the cervical vertebral canal at the 9-month follow-up.

Conclusion

To our knowledge, no prior published literature has revealed Kimura’s disease cases that mimic dumbbell neurogenic tumors. Here, we report such a case of Kimura’s disease for the first time and provide a brief review of the literature.

Kimura's disease affecting multiple body parts in a 57-year-old female patient: a case report

Background

Kimura’s disease (KD) is a rare chronic inflammatory disease with unknown etiology. It usually manifests as a painless soft tissue mass or subcutaneous nodule on one side of the patient’s head and/or neck and rarely affects multiple parts of the body. The disease is more common among young Asian males.

Case presentation

A 57-year-old Chinese woman complained of multiple masses on her body surface. Ultrasonography was used to examine the retroperitoneal, bilateral neck, bilateral supraclavicular, bilateral axillary, and bilateral inguinal superficial lymph nodes. Enlargement of multiple lymph nodes was found in all areas. Many solid nodules were also found in the right parotid gland and right posterior neck area, respectively. Numerous solid nodules were seen on the left chest wall. Laboratory tests showed that the percentage of eosinophils in the whole blood was 39.40%, total immunoglobulin E (IgE) level was > 5000 kU/L, and serum special IgE to Phadiatop (inhaled allergens) and fx5 (food allergens) were 1.01 and 1.04 kUA/L, respectively. After a complete examination, the masses located in the right neck, retroauricular and left axillary regions, and left chest wall were resected directly. Postoperative pathological findings revealed KD.

Conclusions

The case discussed in this study is extremely rare and did not meet the common affected areas and age characteristics of KD. This presentation can be used to improve disease awareness among physicians.

Kimura's Disease: A Rare Cause of Parotid Swelling

Kimura's disease also known as subcutaneous angioblastic lymphoid hyperplasia with peripheral eosinophilia is a rare clinicopathological entity. It is a chronic granulomatous disease of unknown etiology. The clinical presentation varies from subcutaneous swellings of the head and neck region with regional lymphadenopathy with salivary gland involvement to systemic manifestations like nephrotic syndrome. The clinical features are mild, rarely life threatening. The present article is a case report of Kimura's disease presenting as multiple swellings at the left temporal region, left parotid and bilateral post auricular region. Though the lesion is benign, the cosmetic disfigurement caused by the swellings was of significant concern to our patient. MRI Scan was suggestive of a parotid swelling extending into the temporal and post auricular region of the left side. Surgical modality of treatment was adopted- Superficial Parotidectomy with excision of subcutaneous swellings. Histopathological examination confirmed the diagnosis of Kimura's disease. The mode of presentation as multiple large swellings with the involvement of the parotid gland created a diagnostic dilemma, hence this article intends to consider Kimura's disease as a rare but possible cause of a parotid swelling.

Mepolizumab as an effective treatment for Kimura's disease associated with ulcerative colitis: A case report

Kimura's disease was first described by Kimura and Sceto in China in 1937. Kimura disease is a chronic inflammatory disorder of idiopathic etiology. The clinical presentation of Kimura's disease is painless solitary or multiple subcutaneous nodules, asymmetric, mostly in the head and neck region with often association with lymphadenopathy. Typically, the nodules are found on preauricular, submandibular, and popliteal regions as well as oral cavity, larynx, and parotid glands. In the present report, we describe a case of a 27-year-old male presented to our hospital with history of right neck and lip swelling for 10 days. In the history, the patient mentioned that he had bloody diarrhea four to six times day and he lost 10 kg in 1 month. The specimen was sent for histopathological examination which showed the lymph node architecture is preserved with significant increase number of eosinophils which is consistent with Kimura's disease. There is no agreement on the management aspects in Kimura's disease so far. The primary treatment for Kimura's disease includes surgical resection. Additional medical therapy including regional or systemic steroid therapy, cytotoxic therapy, and radiation has also been utilized. Considered as an inflammatory process, the disease has an excellent prognosis, although it may recur locally and wax and wane over time.

Eosinophilia and Kidney Disease: More than Just an Incidental Finding?

Peripheral blood eosinophilia (PBE), defined as 500 eosinophils or above per microliter (µL) blood, is a condition that is not uncommon but often neglected in the management of patients with chronic kidney disease (CKD), acute kidney injury (AKI), or patients on renal replacement therapy (RRT). The nature of PBE in the context of kidney diseases is predominantly secondary or reactive and has to be distinguished from primary eosinophilic disorders. Nonetheless, the finding of persistent PBE can be a useful clue for the differential diagnosis of underdiagnosed entities and overlapping syndromes, such as eosinophilic granulomatosis with polyangiitis (EGPA), IgG4-related disease (IgG4-RD), acute interstitial nephritis (AIN), or the hypereosinophilic syndrome (HES). For patients on RRT, PBE may be an indicator for bio-incompatibility of the dialysis material, acute allograft rejection, or Strongyloides hyperinfection. In a subset of patients with EGPA, eosinophils might even be the driving force in disease pathogenesis. This improved understanding is already being used to facilitate novel therapeutic options. Mepolizumab has been licensed for the management of EGPA and is applied with the aim to abrogate the underlying immunologic process by blocking interleukin-5. The current article provides an overview of different renal pathologies that are associated with PBE. Further scientific effort is required to understand the exact role and function of eosinophils in these disorders which may pave the way to improved interdisciplinary management of such patients.