Kimura disease

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Kimura disease
Diagnosis in short

Kimura disease. H&E stain.

LM eosinophils and thick walled blood vessels with hobnailed endothelial cells
LM DDx angiolymphoid hyperplasia with eosinophilia, drug reaction, infection (parasitic), lymphoma, LCH
Site lymph node, head and neck

Prevalence extremely rare
Blood work eosinophilia

Kimura disease is a rare disease with abundant eosinophils. It may show-up in a lymph node specimen. It is similar to angiolymphoid hyperplasia with eosinophilia.[1]

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:[2]

  • Angiolymphoid proliferation.
    • Thick walled blood vessels with (plump) hobnail endothelial cells.[3]
  • Eosinophils - abundant - key feature.

DDx:

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. URL: http://emedicine.medscape.com/article/1082603-overview. Accessed on: 14 January 2012.
  2. Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 190. ISBN 978-0781775960.
  3. URL: http://emedicine.medscape.com/article/1098777-diagnosis. Accessed on: 8 August 2010.