CPC Summary for Kimura's Disease

H1833/2000 Kimura's Disease

Introduction

chronic inflammatory condition
unknown aetiology
? aberrant allergic response
Kimm and Szeto 1937
Kimura et al 1948

Clinical

Asians/Oriental
85% male
head and neck swelling
associated lymphadenopathy
peripheral eosinophilia
may involve parotid
may have proteinuria

Pathology

proliferating lymphoid tissue with germinal centres
eosinophilic microabscesses
vascular proliferation
fibrosis

Distinguish from ALHE
(angiolymphoid hyperplasia with eosinophilia )

	Kimura's Disease	ALHE
Predominant occurrence	Oriental	Western population
Age / Sex	Younger patients, male	Older patients, female
Nature	Reactive	Endothelial neoplasm
Eosinophilic microabscess	Yes	No
Histiocytoid endothelium	No	Yes
Lymphoid follicles	Common	Sometimes
Other features	Raised Se IgE, Eosinophilia, Proteinuria

Treatment

conservative observation
surgical excision for localized disease
steroid therapy for sensitive areas
case reports from ENT, plastic surgery and ophthalmic disciplines
low-dose radiation for refractory cases
recently report of success with cyclosporin
recurrence in 15 to 40% of cases
some cases persists for years