Motoi M, Wahid S, Horie Y, Akagi T
Department of Pathology, Tottori University School of Medicine, Yonago, Japan.
Acta Med Okayama. 1992 Dec;46(6):449-55. doi: 10.18926/AMO/32634.
In the present study, 14 cases of Kimura's disease were clinicopathologically studied. The disease occurred at ages ranging from 5 to 75 years. The average age was 37.8 years. Sexes were about equally affected. The most common sites were the subcutis of head and neck, and parotid gland. Simultaneous involvement of lymph nodes occurred in 5 cases. Laboratory findings revealed eosinophilia in almost all the patients, but serum IgE levels were not elevated in 2 patients. Lesions were surgically removed and the clinical course thereafter was favorable for all but one case. Histologically, lesions were characterized by lymphoid follicles, granulation tissue with infiltration by many eosinophils, lymphocytes, plasma cells, mast cells and histiocytes, proliferation of blood vessels and fibrosis. Immunohistochemically, IgE reacted strongly in germinal centers, showing a reticular pattern. IgG-, IgA- and lysozyme-positive cells were scattered mainly in interfollicular granulomatous areas. Pathogenesis of this disease is briefly discussed.
在本研究中,对14例木村病进行了临床病理研究。该疾病发生于5至75岁年龄段,平均年龄为37.8岁,男女受累情况大致相同。最常见的部位是头颈部皮下组织和腮腺。5例同时累及淋巴结。实验室检查发现几乎所有患者均有嗜酸性粒细胞增多,但2例患者血清IgE水平未升高。除1例患者外,其余患者均通过手术切除病变,术后临床病程良好。组织学上,病变的特征为淋巴滤泡、有许多嗜酸性粒细胞、淋巴细胞、浆细胞、肥大细胞和组织细胞浸润的肉芽组织、血管增生和纤维化。免疫组织化学显示,IgE在生发中心呈强阳性反应,呈网状分布。IgG、IgA和溶菌酶阳性细胞主要散在于滤泡间肉芽肿区域。本文简要讨论了该疾病的发病机制。