Atypical presentation in Kimura’s disease

Year 2015, Volume: 25 Issue: 1, 46 - 50, 10.02.2015

Ömer Bayır Tuğba Karagöz Emel Çadallı Tatar Ali Özdek Ünsal Han Güleser Saylam Mehmet Hakan Korkmaz

Abstract

Kimura’s disease is a rare chronic inflammatory disorder with an unknown etiology which presents with the involvements of salivary glands and subdermal tissue in the head or neck region, in particular. Besides the most common manifestations of the disease; as the involvements of preauricular region, submandibular region, cervical lymph nodes and major salivary glands, nephrotic syndrome, as an additional systemic pathology, may be also seen due to glomerulonephritis. The differential diagnosis is made with the identification of characteristic histological features as follicular hyperplasia, eosinophil infiltration, and proliferation of the postcapillary venules. Although Kimura’s disease may occasionally resemble angiolymphoid hyperplasia with eosinophilia, both have different clinical and histological features. In this case report, we discuss the clinical, histopathological features and treatment of a 57-year-old male patient admitted with a slowly progressing mass in his right buccal region for almost two years, which was approximately 3x3 cm in diameter and soft to palpation, and was excised completely by an intraoral approach and reported histopatologically as Kimura’s disease in the light of literature.

Keywords

Eozinofilik anjiyolenfoid hiperplazi, kronik hastalık, Kimura hastalığı

Kimura hastalığında atipik tablo

Abstract

Kimura hastalığı özellikle baş boyun bölgesinde subkütanöz doku ve tükürük bezi tutulumuyla seyreden, etyolojisi tam olarak aydınlatılamamış nadir görülen kronik enflamatuvar bir hastalıktır. Hastalık baş boyun bölgesinde en çok preauriküler bölge, submandibüler bölge, servikal lenf nodları ve majör tükürük bezi tutulumu ile görülmekle beraber, glomerulonefrit gelişimine bağlı olarak nefrotik sendrom da hastalığın ek sistemik patolojisi olarak karşımıza çıkmaktadır. Karakteristik histolojik özellikleri olan foliküler hiperplazi, eozinofil infiltrasyonu ve postkapiller venlerde çoğalması ile ayırıcı tanısı yapılmaktadır. Kimura hastalığı eozinofilik anjiyolenfoid hiperplazi ile zaman zaman karıştırılmaktaysa da her iki hastalık ayrı klinik ve histolojik özelliklere sahiptir. Bu olgu sunumunda, iki yıldır sağ bukkal bölgede yavaş progresyon gösteren kitle ile kliniğimize başvuran, fizik muayenesinde sağ bukkal bölgede yaklaşık 3x3 cm boyutlarında yumuşak kıvamlı kitle palpe edilen, intraoral total kitle eksizyonu uygulanan, histopatolojik incelemesi ‘Kimura hastalığı ile uyumlu’ olarak bildirilen 57 yaşında erkek hastanın kliniği, patolojisi ve tedavisi literatür eşliğinde tartışıldı

Keywords

Angiolymphoid hyperplasia with eosinophilia, chronic disease, Kimura’s disease

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