Kimura's Disease: Two Case Reports and a Literature Review

Abstract

Kimura's disease (KD) is an allergic, inflammatory disorder of unknown cause. The typical presentation is in a young Oriental male with nontender subcutaneous swellings in the head and neck region, lymphadenopathy, peripheral eosinophilia, and elevated serum IgE. Many patients with KD also develop renal involvement. Treatment options range from conservative observation for asymptomatic patients to surgical excision, steroid therapy, and radiotherapy for symptomatic patients. Two cases of KD are presented. These emphasize not only the variability of disease presentation, but also the pitfalls of therapy leading to frequent recurrences. The literature is reviewed, summarizing patient presentation, differential diagnosis, current theories on causation, and therapy. A treatment protocol is also proposed.

Angiolymphoid hyperplasia with eosinophilia and Kimura's disease coexisting in the same patient: Evidence for a spectrum of disease

“…Eosinophilic infiltration is usually massive, with the formation of eosinophilic abscesses. 12 A summary of the clinical differences between the previous case report of simultaneous ALHE and Kimura's disease in one patients and the present study is presented in Table 1. It is worth noting that the laboratory test for PPD was strongly positive in the present case.…”

“…5,10,11 This is frequently accompanied by regional lymph node enlargement, 10,11 peripheral blood eosinophilia and elevated serum IgE levels. 5,8,11,12 Nephrotic syndrome 5,12 caused by various types of glomerulonephritis has been more often reported in association with Kimura's disease than ALHE. 13 Histopathologically, in ALHE lymphoid follicles are only occasionally found and the lymphoid infiltration is more diffuse.…”

“…Thick-walled blood vessels are lined with hypertrophic, low cuboidal to dome-shaped 'epithelioid' endothelial cells. 5,11,12 In contrast, Kimura's disease is characterized by the formation of multiple lymphoid follicles 11,12 with germinal centres. Eosinophilic infiltration is usually massive, with the formation of eosinophilic abscesses.…”

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

“…Once a diagnosis has been made pathologically, the patient should be screened for kidney involvement by checking urinary protein levels. If the patient develops symptomatic nephrotic syndrome, medical management with steroids should be initiated [26]. Kimura's disease has an indolent course, and no malignant transformation has been reported in the literature to date.…”

Vincristine treatment of nephrotic syndrome complicated by Kimura disease

“…It was first described in China in 1937 [1], and came to be known as Kimura disease after similar cases were described by Kimura et al in 1948 [2]. The typical presentation is with the triad of slowly enlarging, nontender subcutaneous swellings in the head and neck region involving salivary glands and lymph nodes, peripheral eosinophilia, and raised serum IgE levels [3,4,5,6]. Other sites of occurrence have been reported, including orbit, lacrimal gland, arm, and lymph nodes of the axilla and inguinal region [5,7].…”