Kimura disease

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Kimura disease is a rare disease with abundant eosinophils. It may show-up in a lymph node specimen.

General

  • AKA eosinophilic lymphogranuloma, Kimura disease.
  • Chronic inflammatory disorder - suspected to be infectious.

Clinical:

  • Usually neck, periauricular.
  • Peripheral blood eosinophilia.
  • Increased blood IgE.

Epidemiology

  • Males > females.
  • Young.
  • Asian.

Microscopic

Features:[1]

  • Angiolymphoid proliferation.
    • Thick walled blood vessels with (plump) hobnail endothelial cells.[2]
  • Eosinophils - abundant - key feature.

DDx:

  • Drug reaction.
  • Parasitic infection.

Notes:

  • In a lymph node... it may be signed-out as reactive lymphadenitis with follicular hyperplasia and prominent eosinophils, see comment.
  • Abundant eosinophils: consider Langerhans cell histiocytosis.

Images:

IHC

  • Used to rule-out a clonal population, i.e. lymphoma.

See also

References

  1. Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 190. ISBN 978-0781775960.
  2. URL: http://emedicine.medscape.com/article/1098777-diagnosis. Accessed on: 8 August 2010.