Kimura disease, a rare cause of inguinal lymphadenopathy: A case report

Abstract

Kimura’s disease (KD) is a rare chronic granulomatous disease of unknown etiology that mainly involves damage to lymph nodes, soft tissues, and salivary glands. The clinical symptoms are mainly painless subcutaneous soft tissue masses, often involving head and neck lymph nodes and salivary glands, and are mainly characterized by diffuse eosinophilic infiltration, lymphocyte, and vascular proliferation. There are few reports in the literature that KD affects only inguinal lymph nodes. We report in this study a 41-year-old male patient who presented to the hospital for medical help with soft tissue masses in the groin. Magnetic resonance imaging (MRI) showed multiple abnormal soft tissue nodules around the iliac vessels in the left groin, and a contrast-enhanced scan showed obvious homogeneous enhancement. Diffusion-weighted imaging showed limited movement of water molecules and showed an obvious high signal. Fluoro18-labeled deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) was recommended for further evaluation of the patient’s general condition, and the results showed that except for the radioactive uptake in the lesions in the left groin region, no obvious abnormality was found in the rest of the body. Based on these imaging findings, the patient was first suspected to have malignant lesions, and then the patient underwent histopathological examination, which was confirmed to be KD. Our case study suggests that KD affects only the inguinal lymph nodes is rare and should be considered as one of the imaging differential diagnoses for lymphadenopathy such as lymphoma, metastases, and Castleman’s disease.

Kimura Disease: A Detailed Analysis of Clinical and Radiological Manifestations in a Retrospective Case Series

“…Unlike KD, Tuberculous lymphadenopathy is usually necrotic with central low density, peripheral rim enhancement, and a tendency for matting. 18 KD and ALHE have similar histopathologic and clinical features, both are prevalent in the head and neck and present clinically as subcutaneous masses with lymphoid infiltrates, eosinophils, and angioplasia. However, the prevalence of ALHE is highest among women in the middle-age group, exhibiting no significant ethnic disparities, and lacking any association with renal impairment.…”

“…KD was most frequently observed in the head and neck, which is consistent with previous studies. 15 Other less frequent sites include the arm, 16 thigh, 17 groin, 18 breast, 19 back, 10 and et al Lee et al 10 proposed a male-to-female ratio of 4.5:1 and identified the peak age at diagnosis as middle-aged (median: 41.35 years) for patients with KD. At the same time, the males accounted for 75% of all patients in this study and the mean age at diagnosis was 43 years ranging from 13–71 years, which is similar to the findings of the above-mentioned studies in the literature.…”

“…The density of the involved enlarged lymph nodes is homogeneous on CT, and areas of hypodense cystic necrosis and foci of calcification are rarely seen. 18 It has been suggested that varying degrees of subcutaneous fat atrophy and lesion enhancement indicate different stages of this inflammatory disease spectrum. The more pronounced the subcutaneous fat atrophy, the worse the focal enhancement of KD, reflecting the chronicity of the disease, 11 which was confirmed by Lin et al 29 in a follow-up of the same patients suffering from KD, where gradual fibrosis and sclerosis around the microvessels behind the lesion capillaries increased as time progressed, resulting in decreased lesion enhancement.…”

Clinical and Radiological Features of Kimura Disease: A Retrospective Case Series Study

“…KD was most frequently observed in the head and neck, which is consistent with previous studies 10 . Other less frequent sites include the arm 11 , thigh 12 , groin 13 , breast 14 , back 5 , and et al Lee et al 5 have proposed that the male-tofemale ratio was 4.5:1, and the peak age at diagnosis was middle-aged (median: 41.35 years) for KD patients. At the same time, the males accounted for 75 percent of all patients in this study and the mean age at diagnosis was 43 years ranging from 13-71 years, which is similar to the ndings of the above-mentioned studies in the literature.…”

Kimura disease in children: A report of 11 cases and review of the literature

“…The most frequently affected areas are the head and neck region, especially the parotid glands, salivary glands, and lymph nodes (9). Masses in other areas, such as the groin (10), breast (11), arm (12), thigh (13), and orbit (14), have also been reported. This study was consistent with previous studies that most lesions (14/16) were located in the head and neck region, but there were still two cases located in the back and elbow, respectively.…”