Kimura disease: A rare case in Vietnamese woman

Abstract

Kimura disease (KD) is a rare benign chronic inflammatory condition that predominantly affects Asian males. It is characterized by subcutaneous tissue masses in the head and neck region, enlarged lymph nodes, increased blood eosinophilia, and elevated serum total IgE levels. In this report, we describe a rare case of KD in a young Vietnamese female. A 31-year-old Vietnamese woman presented to the hospital with 2 masses in the bilateral cheeks and 1 mass behind the left ear that persisted for 15 years, recurrent skin itching, elevated serum total IgE levels, and increased blood eosinophilia. No medical history of the individual or family was recorded. We performed an excision biopsy of the postauricular mass that revealed follicular hyperplasia with small vessel hyperplasia, diffuse infiltration of eosinophils in lymphoid follicles, and several eosinophilic microabscesses. After a comprehensive review, the final diagnosis for this patient was KD and atopic dermatitis comorbidity. In conclusion, KD is not limited to males, as this report demonstrated. The histopathological examination plays an important role in the diagnosis of KD. This case illustrated the characteristic description of KD and highlights the need for awareness of this rare disease in Asian women.

Keywords: Angiolymphoid hyperplasia with eosinophilia; IgE; Kimura; Kimura disease; eosinophilia; subcutaneous masses.

Figure 1.

Masses in both cheeks and behind the left ear.

Figure 2.

Eczematous lesions (erythema, vesicles) on the right lower leg.

Figure 3.

Ultrasonography: ultrasound revealed (A) a mass in the left cheek; (B) a mass in the right cheek; (C) swollen lymph nodes along both sides of the sternocleidomastoid muscle; and (D) a left postauricular mass.

Figure 4.

Histopathological examination of the left postauricular mass: (A) Follicular hyperplasia with small vessel hyperplasia and diffuse infiltration of eosinophils into lymphoid follicles (H&E staining ×100); (B) Eosinophilic microabscesses (H&E staining ×400). H&E, hematoxylin and eosin.