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Kimura's disease masquerading as parotid malignancy.

- JRSM Short Rep (2010)

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Vardhman Mahavir Medical College , Safdarjang Hospital, New Delhi 110023 , India.

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This case report highlights the fact that Kimura's disease, although rare, can masquerade as cancer, especially when it involves the parotid gland... Kimura's disease is a rare chronic inflammatory disease of unknown etiology, which was initially described in 1937 but popularized in 1947 by Kimura... In the presented case, on account of history of recurrence and the hard consistency of the gland associated with regional lymphadenopathy there was reason to suspect malignancy... Fine needle aspiration cytology (FNAC) was inconclusive on two occasions and the patient was treated as a suspected case of parotid malignancy... Other biochemical investigations, including liver and kidney function tests, urine examination were within normal limits... As the FNAC from the parotid swelling, as well as the lymph nodes and biopsy from the subcutaneous swellings, were inconclusive on two occasions, malignancy was suspected in view of the history of recurrence and presence of regional lymph nodes, which did not disappear on antibiotic therapy... A diagnosis of Kimura's disease was thus made... Investigations were carried out in view of the histopathological diagnosis to conclusively rule out other possibilities... Kimura's disease is a rare chronic inflammatory lymphoproliferative disorder and usually presents as multiple soft tissue swellings along with lymphadenopathy in the head and neck region with a predilection for parotid and submaxillary glands... It is believed to be a form of chronic allergic disorder due to atopic reaction to a stimulus which is most commonly Candida albicans... Human herpes virus-8 and Epstein-Barr virus have also been suggested as the causative agents without any conclusive evidence... The interfollicular infiltrates are rich in eosinophils and plasma cells that form micro-abscesses... Numerous thin-walled vessels showing sclerosed walls and perivascular eosinophilic infiltrates are also found.

No MeSH data available.


Related in: MedlinePlus

The right parotid swelling with level-II, level-V lymph node enlargement
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SHORTS-10-056F1: The right parotid swelling with level-II, level-V lymph node enlargement

Mentions: A 32-year-old Indian man, a cobbler by trade, presented in May 2003 with a recurrent right parotid swelling which was gradual in onset but had started growing rapidly in the previous six months. There were no symptoms suggestive of facial nerve involvement. He had undergone superficial parotidectomy for pleomorphic adenoma of the right parotid four years previously. He also had a history of chronic generalized itching for the past 10 years for which he was on irregular medication in the form of antihistamines and steroids. Examination revealed a hard, fixed and non-tender, 6 × 6 cm, right parotid swelling with a well-healed scar of previous surgery (Figure 1). There were no features of inflammation or facial nerve involvement. There were two discrete, mobile, non-tender and firm level-II lymph nodes on the right side (Figure 1). He also had multiple, non-tender subcutaneous swellings all over the body including the chest, arms and neck (Figure 2).


Kimura's disease masquerading as parotid malignancy.

- JRSM Short Rep (2010)

The right parotid swelling with level-II, level-V lymph node enlargement
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2984369&req=5

SHORTS-10-056F1: The right parotid swelling with level-II, level-V lymph node enlargement
Mentions: A 32-year-old Indian man, a cobbler by trade, presented in May 2003 with a recurrent right parotid swelling which was gradual in onset but had started growing rapidly in the previous six months. There were no symptoms suggestive of facial nerve involvement. He had undergone superficial parotidectomy for pleomorphic adenoma of the right parotid four years previously. He also had a history of chronic generalized itching for the past 10 years for which he was on irregular medication in the form of antihistamines and steroids. Examination revealed a hard, fixed and non-tender, 6 × 6 cm, right parotid swelling with a well-healed scar of previous surgery (Figure 1). There were no features of inflammation or facial nerve involvement. There were two discrete, mobile, non-tender and firm level-II lymph nodes on the right side (Figure 1). He also had multiple, non-tender subcutaneous swellings all over the body including the chest, arms and neck (Figure 2).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Vardhman Mahavir Medical College , Safdarjang Hospital, New Delhi 110023 , India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

This case report highlights the fact that Kimura's disease, although rare, can masquerade as cancer, especially when it involves the parotid gland... Kimura's disease is a rare chronic inflammatory disease of unknown etiology, which was initially described in 1937 but popularized in 1947 by Kimura... In the presented case, on account of history of recurrence and the hard consistency of the gland associated with regional lymphadenopathy there was reason to suspect malignancy... Fine needle aspiration cytology (FNAC) was inconclusive on two occasions and the patient was treated as a suspected case of parotid malignancy... Other biochemical investigations, including liver and kidney function tests, urine examination were within normal limits... As the FNAC from the parotid swelling, as well as the lymph nodes and biopsy from the subcutaneous swellings, were inconclusive on two occasions, malignancy was suspected in view of the history of recurrence and presence of regional lymph nodes, which did not disappear on antibiotic therapy... A diagnosis of Kimura's disease was thus made... Investigations were carried out in view of the histopathological diagnosis to conclusively rule out other possibilities... Kimura's disease is a rare chronic inflammatory lymphoproliferative disorder and usually presents as multiple soft tissue swellings along with lymphadenopathy in the head and neck region with a predilection for parotid and submaxillary glands... It is believed to be a form of chronic allergic disorder due to atopic reaction to a stimulus which is most commonly Candida albicans... Human herpes virus-8 and Epstein-Barr virus have also been suggested as the causative agents without any conclusive evidence... The interfollicular infiltrates are rich in eosinophils and plasma cells that form micro-abscesses... Numerous thin-walled vessels showing sclerosed walls and perivascular eosinophilic infiltrates are also found.

No MeSH data available.


Related in: MedlinePlus