Kimura's disease in a 50-year-old Tunisian man

Abstract

Introduction: Kimura's disease is an uncommon disease of unknown aetiology affecting men in their thirties from Southeast Asia. The authors report a case of Kimura's disease in a 50-year-old Tunisian man that was diagnosed after surgery.

Case report: This patient had two 2-cm diameter chronic nodular lesions over the right mandible with no local inflammation and no other clinical findings of systemic disease. Histopathological examination showed germinal centre hyperplasia, eosinophilic micro-abscesses and hyperplasia of postcapillary venules, suggestive of Kimura's disease, which was confirmed by the laboratory work-up: elevated total IgE (519g/L), and eosinophilia (580/mm³). Renal function tests were normal.

Discussion: We concluded on a probable diagnosis of Kimura's disease in view of male gender, the head and neck site, the suggestive histological appearance, elevated IgE, and eosinophilia. However, this patient's age and ethnic origin were unusual for Kimura's disease. The main differential diagnosis is angiolymphoid hyperplasia with eosinophilia (ALHE) and renal function tests can distinguish between the two entities due to the kidney damage observed in Kimura's disease.

Keywords: Angiolymphoid hyperplasia with eosinophilia; Epidemiology; Ethnic group; Histopathology.