Kimura’s Disease without Peripheral Eosinophilia: An Unusual and Challenging Case Simulating Venous Malformation on Imaging Studies-Case Report and Review of literature

Abstract

Kimura's Disease (KD) is a rare chronic inflammatory disorder presenting as multiple painless solitary subcutaneous nodules, predominantly in the head and neck region and frequently associated with regional lymphadenopathy and/or salivary gland involvement. Because of painless nature and indolent course, there is usually a delay in the patient's presentation. KD may radiologically mimic other chronic inflammatory conditions like tuberculosis, vascular malformations and neoplasms. Clinical correlation and histological evaluation along with elevated peripheral eosinophil and serum IgE level are considered important for confirmatory diagnosis. We report a case of painless swelling over right submandibular region extending to the right superficial parotid. The haematological reports were within normal limits. Ultrasound (USG), Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiogram (MRA) favoured a diagnosis of venous malformation. However, histopathological examination of excised lesion confirmed a diagnosis of KD. This case proves the possibility of the KD even in the absence of peripheral eosinophilia and/ or elevated serum IgE level, and may mimic venous malformation on imaging studies. Therefore, KD must find a place in the differentials of solitary painless neck swelling even in the absence of peripheral eosinophilia and/or elevated IgE level.

Kimura disease with Allergic Bronchopulmonary Aspergillosis: a case report

“…The youngest patient was a 15-month old African American boy [ 7 ]. Although it is recognized that two typical laboratory examinations are elevated peripheral eosinophil and serum IgE, Vivek et al reported a case of KD without peripheral eosinophilia [ 4 ]. KD is characterized by subcutaneous masses in the head and neck region, sometimes with local lymph node enlargement and salivary gland involvement.…”

“…The diagnosis of KD mainly depends on pathological examination. Treatment should aim to relieve symptoms and preserve aesthetics while preventing recurrences and long-term sequela [ 3 , 4 ]. In this study, we report a case of KD with ABPA in a Chinese man with special clinical manifestations.…”

Kimura Disease With Allergic Bronchopulmonary Aspergillosis: A Case Report

“…The diagnosis of KD mainly depends on pathological examination. Treatment should aim to relieve symptoms and preserve aesthetics while preventing the recurrences and long-term sequels [3,4]. In this study, we report a case of KD with ABPA in a Chinese man with special clinical manifestations.…”

Benign and Malignant Tumours of the Ear and Temporal Bone

“…Macroscopically and radiologically, the tumour looks similar to inflammatory lesion typical for Kimura disease that has to be differentiated on histological level. Moreover, the disease is endemic and found mostly among man in the Far East [25]. Soft tissue haemangiomas, presently known as slow-flow venous malformations, are lesions with a high female predilection, commonly seen in all age groups, especially in children.…”