Kimura Disease: A Case Series and Systematic Review of Clinico-radiological Features

Sangwan, Ankit; Goyal, Ankur; Bhalla, Ashu Seith; Kumar, Atin; Sharma, Raju; Arava, Sudheer; Dawar, Ramesh

doi:10.1067/j.cpradiol.2020.10.003

Cited by 12 publications

(9 citation statements)

References 45 publications

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“…In this paper, among the six patients who underwent CT examination, only one patient presented with type 2, while the rest presented with type 1. A previous systematic review has reported that the lesions showed equal to high intensity on T1weighted images and heterogeneously high signal on T2-weighted images on MRI, which was consistent with our findings (24). The slight differences in image features could be ascribed to the different degrees of vascular proliferation and fibrosis in the primary lesion (26).…”

Section: Discussionsupporting

confidence: 91%

“…In a previous review of ultrasound reports from 58 patients with KD, the mass presented as ill-defined, solid, and heterogeneous echogenic lesions, and blood flow signals could be found partially. Enlarged hilum of lymph node was seen in all involved lymph nodes (24). Gopinathan and Tan classified KD into three types according to the CT images: type 1, the nodular mass with well-defined borders and uniform enhancement; type 2, the patchy lesion of varying degrees of enhancement with an illdefined boundary; type 3, with the above two lesions at the same time (25).…”

Section: Discussionmentioning

confidence: 99%

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Kimura disease in children: A report of 11 cases and review of the literature

Mai

Wang²,

Sun³

et al. 2023

Front. Pediatr.

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IntroductionKimura disease (KD), also known as eosinophilic hyperplastic lymphoid granuloma, is a rare benign chronic inflammatory condition, which is featured with the painless progressive mass located in the subcutaneous area of the head and neck region, elevated peripheral blood eosinophils, and raised serum immunoglobulin E (IgE) levels. KD is uncommon in clinical practice, especially with low incidence in children, so it often leads to misdiagnosis or missed diagnosis in pediatric patients.MethodsThe clinical data of 11 pediatric patients with KD in the authors' institution were retrospectively analyzed.ResultsThere were 11 pediatric patients with KD enrolled in total, including 9 male patients and 2 female patients (sex ratio 4.5:1). The median age at diagnosis stood at 14 years (range 5-18 years), the initial symptoms in all patients included painless subcutaneous masses and focal swelling, the duration of symptoms ranged from 1 month to 10 years, and the average duration was 24.45 months. Six patients had single lesions, and 5 had multiple lesions. The highest proportion of lesion regions were parotid gland (n = 5, 31.3%) and retroauricular (n = 5, 31.3%), followed by cervical lymph nodes (n = 4, 25%), and others (n = 2,12.5; elbow n = 1; back n = 1). The eosinophil absolute count elevated in all patients, ranging from 0.71×109/L to 10.35 ×109/L (normal range 0.02-0.52×109/L). IgE levels were increased in all 7 patients who underwent serum immunoglobulin examination (normal range <100 IU/mL). Three patients received oral corticosteroid treatment while 2 relapsed. Three patients received surgical resection combined with oral corticosteroid treatment, and no patient relapsed. The other 3 patients received surgery and radiotherapy, surgery combined with corticosteroid and cyclosporin and corticosteroid combined with leflunomide respectively, and no patient relapsed.ConclusionBase on the study, it is found that Kimura disease is rare and may have the atypical symptoms in pediatric patients, combination therapy is recommended to reduce recurrence, and long-term follow-up should be performed.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Kimura disease in children: A report of 11 cases and review of the literature

Mai

Wang²,

Sun³

et al. 2023

Front. Pediatr.

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“…Only isolated case reports have been documented from various parts of India 9,10 with three cases from a tertiary referral institute. 11 KD is rare and was first described in the Chinese literature in 1937 as 'eosinophilic hyperplastic lymphogranuloma'. 12 Later in 1948, Kimura reported similar findings in Japanese men, after which the disease became known as KD.…”

Section: Discussionmentioning

confidence: 99%

“…Only isolated case reports have been documented from various parts of India 9,10 with three cases from a tertiary referral institute. 11…”

Section: Discussionmentioning

confidence: 99%

A common presentation of an uncommon pathology: Kimura disease

et al. 2023

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Kimura's disease is a chronic, benign inflammatory condition of the subcutaneous tissue. It presents as painless, subcutaneous nodules of the head and neck, which are firm, painless, and may be single or multiple. It is most commonly seen in young adult Asian men. The nodes remain stable or may slowly enlarge over time. Elevated serum immunoglobulin E (IgE) levels, peripheral blood eosinophilia and lymphoid proliferation with eosinophilic infiltration on histopathological examination are the characteristic features. Spontaneous regression is usually seen. The diagnosis of Kimura's disease can be difficult and misleading, and it is important not to ignore histopathological features.

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“…Clinical features are frequently observed as head and neck masses with eosinophilia. Kimura’s disease also has atypical site involvement of the hands (with or without nerve involvement), breast, buttocks, middle mediastinal mass, along with presentation of an intestinal mass 9–13. Regional lymphadenopathy with increased eosinophil counts is observed in 80%–99% of patients.…”

Section: Discussionmentioning

confidence: 99%

Kimura’s disease of the left arm

Mulla¹,

Bomanwar²,

Sakhare

et al. 2022

BMJ Case Rep

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Kimura’s disease is a rare, benign entity that causes subcutaneous angioblastic lymphoid hyperplasia with eosinophilia. It usually presents with subcutaneous lymphoid swellings with regional lymphadenopathy and salivary gland masses. Kimura’s disease is frequently associated with renal involvement, which includes proteinuria and nephrotic syndrome as the most common presentations. This report presents a case of a man in his early 20s with a swelling in the medial aspect of the distal left arm with two previous episodes of nephrotic syndrome. Multiple enlarged axillary lymph nodes and epitrochlear nodes were noted. Ultrasonography revealed a mixed echogenic mass with enlarged lymph nodes. MRI showed a heterogeneous hyperintense lesion. Image-guided fine-needle aspiration showed multiple lymphocytes and eosinophils suggestive of Kimura’s disease. The swelling was surgically excised under general anaesthesia. Histopathology of the excised mass confirmed the diagnosis of Kimura’s disease.

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Kimura Disease: A Case Series and Systematic Review of Clinico-radiological Features

Cited by 12 publications

References 45 publications

Kimura disease in children: A report of 11 cases and review of the literature

Kimura disease in children: A report of 11 cases and review of the literature

A common presentation of an uncommon pathology: Kimura disease

Kimura’s disease of the left arm

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