Cytologic Features of Kimura’s Disease in Fine-needle Aspirates:A Study of Eight Cases

Abstract

Kimura's disease is a chronic inflammatory disorder of unknown etiology, presenting usually as painless subcutaneous swellings in the head and neck region or in the salivary glands. The cytologic features of fine-needle aspirates of eight cases of Kimura's disease were studied with reference to the histologic appearance of the subsequent surgical specimens. In the cytologic smears, the prominent feature was the presence of significant numbers of eosinophils in a background of lymphoid cells. Fragments of collagenous tissue and Warthin-Finkeldey polykaryocytes occasionally were seen. In the cell block, vascular proliferation and fibrosis were useful features, providing further support to the diagnosis. The constellation of these features is characteristic of Kimura's disease and should suggest this diagnosis in the appropriate clinical setting. For initial diagnosis, excisional biopsy is important for the exclusion of malignant lymphoma, histiocytosis X, angiolymphoid hyperplasia with eosinophilia and other reactive lymphadenopathies. Nonetheless, fine-needle aspiration cytology may be valuable in the diagnosis of recurrent lesions of Kimura's disease and may spare the patient from repeated biopsies.

Kimura’s Disease of the Intraparotid Lymph Nodes: Fine Needle Aspiration Biopsy Findings

“…FNAB is a safe and highly accurate procedure and should be considered for the initial assessment of a parotid mass. The case presented here, in which the affected structures were two intraparotid lymph nodes and not the salivary gland parenchyma, is comparable with case 7 in the Chow et al [23] series and with the well-documented observation reported by Jensen [25]. In our case, however, diagnosis and management were based on the FNAB.…”

“…Eosinophils and isolated granules interspersed within the cytological smear are often very numerous; sometimes sparse polykaryocytes are also detectable. Fragments of collagenous sclerotic tissue may be noted here and there [23].…”

Fine-needle aspiration cytology in soft tissue tumors: How far did we go??

“…It is often diagnosed in male patients. [15] Although, IPT is placed within the neoplastic category, it is best-regarded as a morphologic entity showing mainly inflammatory cells with a pleomorphic spindle cell component mimicking a tumor. The term, "pseudotumor" is appropriate, and as the atypical spindle cells are myofibroblastic, it can be termed as an inflammatory myofibroblastic tumor.…”

Kimura’s Disease

“…The lymphoid population consisted of a mixture of small and large lymphocytes and immunoblasts, representing the corresponding distinctive histologic finding of lymphoid follicles with germinal centers. 4 Occasionally WF-type giant cells, which are actually polykaryocytes, were seen. Although the presence of these giant cells has been considered an important diagnostic feature by many authors, 14,18 others have not documented their presence, nor is it necessary for the diagnosis.…”

“…7 Although it has been reported in the Eastern literature, 13,29 there are very few reports on the cytology of Kimura's disease; only four cytologic reports appear in the English-language literature. 3,4,14,18 Described initially by Kimura, followed by Kim, Szeto and Kung, these lesions tend to occur in the head and neck region as subcutaneous masses, especially in the preauricular region, often affecting the salivary glands and adjacent muscles. 1,9,17,22,24 Regional lymph nodes are usually involved, with accompanying raised IgE levels in the serum and peripheral blood eosinophilia.…”