Kimura’s disease: a diagnostic and therapeutic enigma

Abstract

Kimura’s disease is a rare chronic inflammatory disorder present in 2nd and 3rd decade. It has a predilection for head and neck region presenting as a slowly growing painless swelling. It is usually accompanied by peripheral eosinophilia and elevated serum IgE and hence it was initially thought to be of allergic origin. Histologically the lesions are characterized by reactive hyperplasia of lymph nodes, eosinophilic infiltration and increase in postcapillary venules. Authors have reported a male patient with a slowly growing right sided neck swelling which is recurring even after course of steroids and excision done twice at an interval of 6 months. Kimura’s disease although a benign Lymphoid disorder but the incidence of recurrence despite taking treatment is a cause of much concern for the patient.

Cervical lymphadenopathies: a diagnostic crisis

“…6,7 It is a benign inflammatory disease mostly affecting the head and neck region. 8 It usually involves the subcutaneous tissue, lymph nodes and the salivary glands. 8 They are rarely reported in other areas like eyelids, lacrimal glands, orbit, axilla, groin, forearm, and kidneys.…”

“…8 It usually involves the subcutaneous tissue, lymph nodes and the salivary glands. 8 They are rarely reported in other areas like eyelids, lacrimal glands, orbit, axilla, groin, forearm, and kidneys. 9 It presents as solitary or multiple sub-cutaneous nodules in the head and neck region.…”

“…9 It presents as solitary or multiple sub-cutaneous nodules in the head and neck region. 8 It is typically seen Recurrence is very common with upto 25%-40% of surgically treated cases. There are no reports of malignant transformation so far.…”

“…8 Renal abnormalities notably nephrotic syndrome and glomerulonephritis are seen in Kimura's disease. 10 Proteinuria is present in 12-16% of cases.…”

“…10 Proteinuria is present in 12-16% of cases. 8 CT scan of neck may aid in finding out the extent of the disease. 6 Histopathologically, the most characteristic finding is folliculolysis with eosinophilic microabcess and parafollicular eosinophilic infiltration.…”