Fukunaga Masaharu
Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan.
APMIS. 2005 May;113(5):379-84. doi: 10.1111/j.1600-0463.2005.apm_113510.x.
A case of juvenile temporal arteritis, which is a rare vascular lesion in children and young adults, associated with Kimura's disease in a healthy 23-year-old asymptomatic man is described. The patient presented with a painless 2.5 cm nodule with eosinophilia and normal erythrocyte sedimentation rate. Histologically, the left superficial artery showed marked intimal thickening with moderate eosinophilic infiltrates, constriction of the vascular lumen, focal disruptions of the internal elastic lamina and media, moderate eosinophilic infiltrates in the adventia, and absence of giant cells. The subcutaneous tissue surrounding the artery was characterized by lymphofollicular hyperplasia, marked eosinophilic infiltrates in the intra- and extra-follicles with abscess, capillary proliferations, lymphocytic, plasma cell and mast cell infiltrates, and fibrosis in the interfollicular region. Immunohistochemically, reticular, positive IgE staining was observed in the germinal centers. Clinically and histologically, the lesion was consistent with juvenile temporal arteritis associated with Kimura's disease. The findings indicate that both entities are closely related and juvenile temporal arteritis may be secondary to Kimura's disease.
本文描述了一例青少年颞动脉炎病例,这是一种在儿童和青年中罕见的血管病变,发生于一名23岁健康无症状男性,与木村病相关。患者表现为一个2.5厘米无痛性结节,伴有嗜酸性粒细胞增多和红细胞沉降率正常。组织学上,左侧浅表动脉显示内膜显著增厚,伴有中度嗜酸性粒细胞浸润,血管腔狭窄,内弹力膜和中膜局灶性破坏,外膜有中度嗜酸性粒细胞浸润,且无巨细胞。动脉周围的皮下组织表现为淋巴滤泡增生,滤泡内和滤泡外有明显的嗜酸性粒细胞浸润并伴有脓肿,毛细血管增生,淋巴细胞、浆细胞和肥大细胞浸润,以及滤泡间区域纤维化。免疫组化显示,生发中心有网状、阳性IgE染色。临床和组织学上,该病变符合与木村病相关的青少年颞动脉炎。这些发现表明这两种疾病密切相关,青少年颞动脉炎可能继发于木村病。