Kimura disease: diagnostic challenges and clinical management

• Published in: American journal of otolaryngology 2012-03, Vol.33 (2), p.259-262
• Main Authors: Kapoor, Nimmi S., MD, O'Neill, James P., MD, Katabi, Nora, MD, Wong, Richard J., MD, Shah, Jatin P., MD
• Format: Article
• Language: English
• Subjects: Adult; Angiolymphoid Hyperplasia with Eosinophilia - complications; Angiolymphoid Hyperplasia with Eosinophilia - diagnosis; Angiolymphoid Hyperplasia with Eosinophilia - surgery; Biological and medical sciences; Biopsy, Needle; Blood; Cytokines; Diagnosis, Differential; Disease; Eosinophils - pathology; Follow-Up Studies; Hematologic and hematopoietic diseases; Humans; Lymph Nodes - pathology; Lymphatic Diseases - diagnosis; Lymphatic Diseases - etiology; Lymphatic Diseases - surgery; Magnetic Resonance Imaging; Male; Medical sciences; Men; Mortality; Neck; Neck Dissection - methods; Other diseases. Hematologic involvement in other diseases; Otolaryngology; Otorhinolaryngology. Stomatology; Postoperative period; Surgery; Young Adult
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2011.05.005

Abstract Kimura disease is a rare inflammatory lesion of the head and neck region, usually seen in young Asian men. Patients usually present with a painless mass involving a major salivary gland with lymphadenopathy. Current studies suggest an immunologic mechanism for the pathogenesis of this disease entity. Histopathologically, this tumor is composed of vascular proliferation and lymphoid infiltrate rich in eosinophils. The immunohistochemical findings are usually nonspecific but might help in eliminating malignancies. The role of fine needle aspiration (FNA) and biopsy procedure appears to be limited in making the histologic diagnosis of Kimura disease. The natural history of the disease, however, appears to be indolent, without any malignant transformation reported, although recurrence can be frequent. Here, we describe 2 cases of Kimura disease with differing presentations, diagnostic difficulties, and their clinical management. The difficulties encountered in establishing an accurate preoperative diagnosis and the complexity of surgical management highlight the need for an index of suspicion for this clinical entity while mandating appropriate surgical management to minimize operative morbidity and reduce the risk of recurrence.