Abstract

Kimura's disease is a rare chronic inflammatory condition which affects predominantly males of Asian descent. This is a case report of this condition. A 45-year-old male presented with a subdermal lesion posterior to the left ear with associated peripheral eosinophilia. The specimen excised consists of five irregular pieces of firm, grey-white tissue ranging from 5x3x2mm to 10x8x5mm. Microscopically, the tissue fragments show aggregates of lymphoid tissue set within a dense, sclerotic background. There is prominent lymphoid hyperplasia with many of the follicles broken up by small lymphoid cells. The infiltrate consists of small lymphocytes and is accompanied by prominent postcapillary venules as well as large numbers of eosinophils and fewer numbers of histiocytes and Langerhans cells. The lymphoid infiltrate is a mixture of B cells (CD20 positive) and small numbers of T cells (CD3 positive). No atypical cells are seen within the infiltrate. The appearances are consistent with so called Kimura's disease which presents as a head and neck lymphadenopathy with associated soft tissue mass, late stage sclerosis and peripheral eosinophilia. The aetiology is unknown. The lesions are benign although recurrence may occur after surgical excision.

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