Kimura’s Disease- A Diagnostic Challenge

Abstract

Kimura’s disease is a rare, benign, chronic inflammatory disease with an unknown etiology, which predominantly affects Asian males. It has predilection for the head and neck region, and primarily involves the major salivary glands and is accompanied with loco-regional lymphadenopathy. It is therefore often misdiagnosed for a salivary gland tumor or lymphadenopathy secondary to metastases, lymphoma or tuberculosis. We present a case of Kimura’s disease in a middle aged Chinese male patient manifesting as painless lumps over the left jaw and neck. Based on the CT scan, the differential diagnoses of lymphomatous/metastatic adenopathy affecting the left cervical and parotid nodes or a primary left parotid malignancy with ipsilateral metastatic adenopathy were considered. However, a fine needle aspiration biopsy of the left sided adenopathy yielded the diagnosis of Kimura’s disease. The triad of subcutaneous masses in head and neck region, regional lymphadenopathy and masses in one or more of the major salivary glands should raise the suspicion of Kimura’s disease.