Kimura Disease - A Rare Case Report

Kimura disease is a chronic inflammatory disorder usually affecting young adults aged between 20-40years, men are affected more commonly than women [1]. It involves subcutaneous tissues and lymph nodes predominantly in the head and neck region and is characterized by angiolymphoid proliferation and eosinophilia [2]. It classically presents as a non-tender subcutaneous swelling in the head and neck region predominantly in preauricular and submandibular area. It may be associated with lymphadenopathy, marked peripheral eosinophilia and elevated Ig E levels [2]. Histopathology shows hyperplastic lymphoid follicles with prominent germinal centre, hyperplasia of endothelial cells in postcapillary venule, abundant eosinophil infiltration often involving germinal centre, polykaryocytes of Warthin-Finkeldey type and Ig E deposition in germinal centre [2]. A male patient aged 45years presented with painless swelling in the left inguinal region of 4 months duration. On USG moderate hydrocele was noted on both sides and cellulitic changes in the left inguinal lymph nodes. Multiple sections studied from the excised lymph node showed dense infiltration by plasma cells and eosinophils in the paracortex and capsule, eosinophilic microabscess in focal areas, plump endothelial cells and many blood vessels. Based on the histopathological findings the diagnosis of Kimura disease was made.