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Postoperative Specimen Postoperative histology showed diffuse fibrosis and infiltration by lymphoid tissue showing prominent reactive germinal centers with eosinophilia. The interstitial areas showed vascularization and infiltration by eosinophils consistent with Kimura' disease (Fig.4). Currently, the patient is doing well with no recurrence observed during his 6month follow up.
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Introduction
Kimura’s disease (KD) is an allergic inflammatory disorder of unknown etiology endemic in Orientals. Kimura’s disease was first mentioned by Kimm and Szeto in China in 1937. Kimura’s disease is commonly encountered in Asia and is mostly reported in Japan, China, Singapore and Honkong. However, only a few cases have been reported in the...
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Context 1
... 18-year-old male presented with left postaural swelling, which was progressively increasing for 8 years. Occasionally, he complained of itching over the swelling. During clinical examination, the swelling was observed to be approximately 5 x 4 cm, solitary, non tender, firm, with ill defined margins (Fig.1). The overlying skin was thickened and erythematous. There was associated bilateral cervical lymphadenopathy. No similar swelling was found anywhere else in the body. There was no family or personal history of similar swellings. During routine blood examination, the absolute eosinophil count was observed to be raised (2780). FNAC was inconclusive. Open biopsy, taken from the lesion under local anesthesia, was suggestive of angiolymphoid hyperplasia with eosinophilia. CT scan showed a homogeneously enhancing lesion in the subcutaneous plane (Fig.2). Meanwhile the patient was given oral steroids, anti-histaminic and diethylcarba- mazine but failed to achieve any reduction in the size of the swelling. Therefore, surgical excision of the swelling was performed under general anesthesia. Intraoperatively, the swelling was found in the subcutaneous tissue and was easily dissected out from the surrounding tissue in toto (Fig.3). (Fig.4). Currently, the patient is doing well with no recurrence observed during his 6- month follow up. ...
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Background
Kimura disease is characterized by inflammation, with its underlying causes remaining uncertain. There is a lack of comprehensive and systematic research on the pathology of this condition in pediatric patients. Our objective is to study the clinical and pathological attributes of Kimura disease in pediatric patients and investigate the potential diagnostic significance of immunoglobulin E (IgE) in this context.
Methods
Clinical and laboratory information, pathological characteristics, and follow-up data were correlated to examine the distinctive features. Immunohistochemistry, acid-fast staining, and molecular assay were used to identify the presence of IgE and pathogens.
Results
We conducted an analysis of five cases of Kimura disease in pediatric patients at our hospital. The patients’ ages ranged from 5 years and 7 months to 14 years and 2 months, with 4 (80%) being male. The most common site was the head and neck region, particularly the postauricular subcutaneous area. Eosinophilia was observed in four patients (80%), and two patients (40%) had elevated serum immunoglobulin E (IgE) levels. Histopathological changes included eosinophilic infiltrates, follicular hyperplasia, and the proliferation of postcapillary venules. Immunohistochemical results supported the reactive nature of the lymphoid process and IgE deposition in the follicle, while no specific pathogens were discovered by special staining. All patients underwent surgical excision, and none experienced recurrence in their original location.
Conclusion
Children with Kimura disease show distinct eosinophilic and IgE alterations in both laboratory findings and pathological features. The application of immunohistochemical staining of IgE could serve as a promising marker for diagnosing Kimura disease.
Background:
Kimura's disease (KD) is known to be dominant among young Asian men, but it can also occur in middle- and advanced-aged people. The clinical characteristics of KD, especially by age, are not well known.
Aim:
This study was performed to investigate the effects of age on the clinical characteristics of KD.
Design:
We conducted a case series study.
Methods:
All case studies of patients diagnosed with KD were collected via a PubMed search of studies published until August 2018. The data were analyzed by age group.
Results:
In total, 215 studies were reviewed (238 patients; mean age of 36 years). The male: female ratio was 4:1 overall, 17:1 in patients aged <20 years, 4:1 in patients aged 20 to39 years, and 2:1 in patients aged ≥40 years (p = 0.01). The percentage of patients with pruritus was 15.4% overall, 3.8% in patients aged <20 years, 15.5% in patients aged 20 to 39 years, and 21.7% in patients aged ≥40 years (p = 0.02). The time to diagnosis was 5.3 years overall, 3.2 years in patients aged <20 years, 4.7 years in patients aged 20 to 39 years, and 7.1 years in patients aged ≥40 years (p < 0.01).
Conclusions:
The proportion of female patients affected, the incidence of pruritus, and the time to diagnosis increased as the patients' age increased. There were no significant age-related differences in region/race, complications, multiplicity, laterality, anatomical distribution, maximum size, eosinophil count, IgE level, initial treatment, recurrence, or outcomes. This may be useful information for the diagnosis of KD.
