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Kimura’s Disease: A Rare Clinical Entity for A Head & Neck Surgeon

Ali Azim, Asad Azim, Talat Waseem, Kh. M. Azim

Abstract


Background: Kimura’s disease, previously known as a variant of angiolymphoid hyperplasia with eiosinophilia (ALHE), is now considered a distinct clinical entity. In contrast to ALHE, it presents with exuberant systemic autoimmune response involving lymphoid system more readily and at times salivary glands. Disease typically presents with a head and neck region mass associated with peripheral eiosinophilia and raised IgE levels with occasional but concurrent renal or pulmonary involvement in advanced cases. Association of this disease to allergic rhinitis has not been reported in the previous medical literature.

Case Presentation: Young Asian male was referred to us with suspicion of primary parotid tumor. He had typical symptom complex of allergic rhinitis with recurrent frontal and parotid region swelling associated with peripheral eiosinophilia (25%) and elevated IgE levels (1703 IU/mL). FNAC of the lesions was inconclusive and hence underwent US- guided core biopsy, which revealed a diagnosis of Kimura’s disease. Superficial parotidectomy and excision of frontal lesion were performed and histopathology of the lesion confirmed Kimura’s disease with involvement of parotid gland. Now the patient is on oral corticosteroids and mast cell stabilizers without recurrence for last 3 months since operative intervention.

Conclusions: Kimura’s disease rarely involves parotid gland and its association with allergic rhinitis is being reported first time in medical literature to best of our knowledge. Kimura’s disease should include in the differential diagnosis of a parotid region mass.


Keywords


Kimura’s disease; parotid gland; angiolymphoid hyperplasia with eiosinophilia; ALHE

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References


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