A Difficult-to-Diagnose Case of Kimura’s Disease of the Parotid Gland

概要

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Kimura’s disease is a chronic non-neoplastic entity that was first described by Kimura et al. in Japan in 1948. It predominantly occurs in Asian males during the second and third decades of life. The major physical manifestation of this disorder is slowly enlarging subcutaneous masses often found in the head and neck, especially in the salivary glands, with or without lymphadenopathy, usually in association with peripheral blood and tissue eosinophilia in combination with a markedly increased serum IgE concentration. A 31-year-old male presented to our department with a 5-year history of a swelling of infraauricular region. Peripheral blood examination revealed slight eosinophilia. MRI showed a slight ill-defined mass in the parotid gland with a low-intensity signal in both T1- and T2-weighted images. We could not arrive at the correct histological diagnosis by fine needle aspiration cytology. A superficial parotidectomy was performed, and histopathological examination revealed multiple hyperplastic lymph follicles with a reactive germinal center in the subepithelial layer. A large number of eosinophils had infiltrated the interfollicular areas. Therefore, based on the histopathology, the diagnosis of Kimura’s disease was confirmed.