[A case report of Kimura's disease causing visual dysfunction with remarkable eyelid swelling].

PURPOSE

We report a case of Kimura's disease involving the eyelids, presenting with bilateral eyelid swelling so severe that the eyelids could not be opened.

CASE

A 37-year-old man presented with eyelid swelling and was unable to open both eyelids. He noted swelling and mass of bilateral eyelids since a year previously, and the masses enlarged gradually impairing eye-opening. Hard soft elastic tumors were palpated in both eyelids. Blood examination revealed marked peripheral blood eosinophilia and an increased serum IgE level. On T 1-weighted MR images, the tumors were observed as isointense masses compared to the extraocular muscles. On T 2-weighted images, the tumors showed hypointense signals while some parts were hyperintense compared to the extraocular muscles. On Gd-enhanced T 1-weighted images, the tumors demonstrated marked enhancement. The tumors in both eyelids were extirpated en bloc. Histopathology of the tumors demonstrated many lymphoid follicles and infiltration of large numbers of eosinophils and lymphocytes. Eosinophilic abscess and proliferation of blood capillaries were observed between the lymphoid follicles. These findings led to a diagnosis of Kimura's disease. PCR revealed clonal rearrangement of the T cell receptor gene.

CONCLUSION

Kimura's disease may cause remarkable eyelid swelling and lead to visual dysfunction. Since recurrence of Kimura's disease is known to be associated with clonal rearrangement of T cell receptor genes, similar cases should be followed carefully for recurrence.