Kimura's disease: The CT and MRI characteristics in fifteen cases

Zhang, Rong; Ban, Xiao Hua; Mo, Yun Xian; Lv, Mingming; Xiao, Duan; Shen, Jun; Li, Jian Peng; Liu, Xue Wen; Xie, Chuan

doi:10.1016/j.ejrad.2010.09.016

Cited by 38 publications

(38 citation statements)

References 13 publications

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“…KD is a rare idiopathic entity that has been linked to allergic reactions and/or autoimmune responses characterized by peripheral blood eosinophilia and elevated serum Ig E levels (1,6). A close relationship between the lesion size and the degree of eosinophilia was reported (1).…”

Section: Discussionmentioning

confidence: 99%

“…It has been Clinically, the lesions are often misdiagnosed as salivary gland malignancy because of the diffuse nature of the disease (7). Other reported clinical associations include atopic dermatitis, allergic rhinitis, asthma, urticaria and renal disease (6).…”

Section: Discussionmentioning

confidence: 99%

“…Radiological findings described in the literature include subcutaneous head and neck nodules, which are often misdiagnosed as salivary gland malignancy (5). These lesions may also occur in the axilla, groin, trunk, abdomen and peripheral limbs (6). A PubMed and Medline search using the key words "Kimura's disease or Kimura disease" revealed no reports of a rare association of typical head and neck findings with distant subdermal hip and buttock lesions.…”

Section: Introductionmentioning

confidence: 99%

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An Unusual Clinical Presentation of Kimura Disease Manifesting with a Typical Cephalocervical Lesion and an Atypical Subcutaneous Hip Mass Lesion

et al. 2016

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Kimura's disease (KD) is a rare lymphoproliferative inflammatory disorder, typically presenting as firm, painless or pruritic single or multiple subcutaneous lesions in the head and neck, especially in the parotid and submandibular regions. We herein report a case of a 39-year-old Japanese man presenting with a typical cephalocervical KD lesion around the salivary glands with a rare association with a distant subcutaneous mass at the hip. We also emphasize the radiologically and clinically important features in the differential diagnosis and management. To the best of our knowledge, this case is the first report of KD manifesting with a typical cephalocervical lesion and an atypical subcutaneous hip mass lesion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An Unusual Clinical Presentation of Kimura Disease Manifesting with a Typical Cephalocervical Lesion and an Atypical Subcutaneous Hip Mass Lesion

et al. 2016

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“…The diagnosis of KD can be based on characteristic findings following surgical excision in conjunction with peripheral eosinophilia and elevated serum immunoglobulin E (IgE) levels (10). In a review of several cases, no clear conclusions were made regarding the cause of KD (11), and computed tomography and magnetic resonance imaging examinations exhibited no specific intensity or signal changes (10). Clinically, KD is typically diagnosed by oral and maxillofacial surgeons when a patient has suffered from a long history of a mass with blood eosinophilia and increased serum IgE levels, and presents with single or multiple painless subcutaneous masses (12).…”

Section: Discussionmentioning

confidence: 99%

Kimura's disease of the right cheek: A case report

Luo

Liu³

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. Kimura's disease (KD), a chronic inflammatory disease of uncertain etiology, manifests as a painless subcutaneous swelling in the head and neck region that involves major salivary glands and regional lymph nodes. To date, the majority of cases of KD have been documented in Asian males aged 20-30 years. However, the number of reported cases of KD involving the oral and maxillofacial area is limited, and since the masses appear similar to cysts or benign tumors, the establishment of an accurate pre-operative diagnosis is challenging. The accurate diagnosis of KD is considered to require surgical excision followed by histopathological examination. In the current case, a 39-year-old man was admitted to hospital in October 2011 with a swelling evident on his right cheek. Surgical excision was performed, and histopathological observation was carried out. The formation of a lymphoid nodule accompanied by the vigorous proliferation of small blood vessels, eosinophilic infiltration and thickened cell walls were observed. No sign of recurrence of the mass has yet been observed, on the basis of the telephone follow-up interviews. These findings provide a novel insight useful in the diagnosis of KD in the oral and maxillofacial area. IntroductionKimura's disease (KD), a chronic inflammatory disease characterized by slowly growing subcutaneous nodules and benign reactive lymphoid proliferation in the face and neck region is predominantly observed in young Asian men (1). It is considered to be a benign disease involving subcutaneous tissues, major salivary glands and lymph nodes in the area of head and neck (2). Although numerous researchers have conducted investigations into the etiology of KD (3-5), reports concerning the underlying etiology of KD in oral and maxillofacial areas are limited (6). Until recently, the underlying cause of KD was unknown (7) In addition, the diagnosis of KD prior to surgery has proven challenging, since a clinical examination alone may not give an accurate diagnosis (8). In the present study, a case of KD affecting the oral and maxillofacial areas was evaluated and the corresponding pathogenesis was reported. Case reportThe patient in the present case was an otherwise healthy 39-year-old man. The patient was admitted to the Shanghai East Hospital Affiliated with Tongji University (Shanghai, China) in October 2011 with an obvious swelling on his right cheek (Fig. 1A). The patient had a 2-year history of non-painful swelling of the right-side cheek without additional symptoms. Three weeks prior to presentation, the patient sought medical attention and self-treated with an anti-bacterial agent administered orally (the name and dose of the drug are unknown). After a 3-week treatment, the mass only minimally responded to over-the-counter medication and no improvement in the patient's condition was exhibited. Therefore, the patient was referred to our hospital for further evaluation and treatment. According to the investigation conducted at the hospital, there was no history of recent febril...

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“…The typical triad of presentation includes painless subcutaneous masses (predilection for the head and neck region, especially the postauricular and parotid areas), regional lymph node enlargement, and involvement of salivary glands. peripheral blood are known associations (12). Lesions can be solitary or multiple (localized or disseminated).…”

Section: Kimura Diseasementioning

confidence: 99%

Approach to intensely enhancing neck nodes

Karandikar

Gummalla²,

Loke³

et al. 2016

Diagn Interv Radiol

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E nlarged cervical lymph node is one of the most common causes of a mass lesion in the neck. Although ultrasonography can be used as an initial investigative tool to assess neck nodes, computed tomography (CT) and magnetic resonance imaging (MRI) have an advantage in assessing disease extent and evaluating any primary head and neck pathology. MRI has a very high contrast sensitivity compared with CT and hence most lymph nodal diseases show postcontrast enhancement, making it difficult to appreciate differential nodal enhancement. In addition, absence of direct measurement of signal intensity makes interpretation subjective. In contrast, CT scan can differentiate varying degrees of enhancement based on Hounsfield unit (HU) values rendering higher objectivity. To reduce radiation exposure, a contrast-enhanced CT scan is performed directly in most cases. In pediatric patients, however, Doppler ultrasonography and MRI may take preference as investigative tools.Almost all conditions affecting cervical nodes cause postcontrast enhancement. Of these, only few conditions cause intense enhancement in cervical nodes. We define intense contrast enhancement as above 120 HU (Fig. 1). The sternomastoid muscle shows a CT value of 60-80 HU on postcontrast scan for comparison. In this pictorial essay, we discuss the various causes of intensely enhancing solid neck nodes and important features that may help differentiate these conditions. The images given below were obtained on two CT machines: Siemens Somatom Definition AS (128 slice, 120 Kv, 250 mAs, slice thickness 1 mm, scan interval 0.8 mm, pitch 0.8) and Spiral CT systems CT/I GE Medical systems (single slice spiral CT, slice thickness 5 mm, no overlap).Common causes of intensely enhancing neck nodes are as follows: metastases from hypervascular primaries, most commonly papillary thyroid carcinoma; Castleman disease; Kikuchi disease; Kimura disease; and rarely, angioimmunoblastic lymphadenopathy (1). Metastatic neck nodes from hypervascular primary malignancyMetastatic neck nodes from hypervascular primaries show intense enhancement due to increased vascularity. The primary hypervascular malignancies that metastasize to neck nodes include papillary and medullary carcinoma of thyroid, renal cell carcinoma, Kaposi sarcoma, and neuroendocrine tumors. Most common cause of hypervascular metastases from a head and neck primary is the papillary thyroid cancer. 1) Thyroid cancer: Papillary thyroid cancer has a high propensity to metastasize to nodes (30%-90%); other thyroid cancers with frequent node metastasis are medullary carcinoma (50%) and anaplastic carcinoma (40%) (Figs. 2, 3) (2). Besides intense enhancement, nodal calcification (50%-69%) and cystic change (20%) may also be noted. In larger tumors, CT scan may show a thyroid mass invading adjacent structures (trachea, esophagus). A heterogeneous thy- Here, we present a pictorial review of intensely enhancing neck nodes. While enhancement in a cervical node is a common radiologic finding on contrast-enhanced computed tomogra...

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Kimura's disease: The CT and MRI characteristics in fifteen cases

Cited by 38 publications

References 13 publications

An Unusual Clinical Presentation of Kimura Disease Manifesting with a Typical Cephalocervical Lesion and an Atypical Subcutaneous Hip Mass Lesion

An Unusual Clinical Presentation of Kimura Disease Manifesting with a Typical Cephalocervical Lesion and an Atypical Subcutaneous Hip Mass Lesion

Kimura's disease of the right cheek: A case report

Approach to intensely enhancing neck nodes

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