Department of Surgery, New York Presbyterian Hospital, Cornell, 1275 York Avenue, New York, NY 10021, USA.
Am J Otolaryngol. 2012 Mar-Apr;33(2):259-62. doi: 10.1016/j.amjoto.2011.05.005. Epub 2011 Jul 16.
Kimura disease is a rare inflammatory lesion of the head and neck region, usually seen in young Asian men. Patients usually present with a painless mass involving a major salivary gland with lymphadenopathy. Current studies suggest an immunologic mechanism for the pathogenesis of this disease entity. Histopathologically, this tumor is composed of vascular proliferation and lymphoid infiltrate rich in eosinophils. The immunohistochemical findings are usually nonspecific but might help in eliminating malignancies. The role of fine needle aspiration (FNA) and biopsy procedure appears to be limited in making the histologic diagnosis of Kimura disease. The natural history of the disease, however, appears to be indolent, without any malignant transformation reported, although recurrence can be frequent. Here, we describe 2 cases of Kimura disease with differing presentations, diagnostic difficulties, and their clinical management. The difficulties encountered in establishing an accurate preoperative diagnosis and the complexity of surgical management highlight the need for an index of suspicion for this clinical entity while mandating appropriate surgical management to minimize operative morbidity and reduce the risk of recurrence.
木村病是一种罕见的头颈部炎性病变，通常见于年轻的亚洲男性。患者通常表现为无痛性肿块累及大涎腺伴淋巴结病。目前的研究提示这种疾病实体的发病机制与免疫有关。组织病理学上，这种肿瘤由血管增生和富含嗜酸性粒细胞的淋巴样浸润组成。免疫组化表现通常是非特异性的，但有助于排除恶性肿瘤。细针抽吸（FNA）和活检程序在做出木村病的组织学诊断方面作用似乎有限。然而，该病的自然病程呈惰性，尚无恶性转化的报道，尽管复发可能频繁。在此，我们描述了 2 例木村病，其表现、诊断困难和临床处理存在差异。在建立准确的术前诊断方面遇到的困难以及手术处理的复杂性突出表明，在考虑这种临床实体时需要保持警惕，并要求进行适当的手术处理，以最大程度地减少手术发病率并降低复发风险。
