Service maxillo-faciale et ORL, hôpital d'instruction des armées Bégin, 94160 Saint-Mandé, France.
Service maxillo-faciale et ORL, hôpital d'instruction des armées Bégin, 94160 Saint-Mandé, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Apr;134(2):127-129. doi: 10.1016/j.anorl.2016.12.001. Epub 2016 Dec 28.
Kimura's disease is an uncommon disease of unknown aetiology affecting men in their thirties from Southeast Asia. The authors report a case of Kimura's disease in a 50-year-old Tunisian man that was diagnosed after surgery.
This patient had two 2-cm diameter chronic nodular lesions over the right mandible with no local inflammation and no other clinical findings of systemic disease. Histopathological examination showed germinal centre hyperplasia, eosinophilic micro-abscesses and hyperplasia of postcapillary venules, suggestive of Kimura's disease, which was confirmed by the laboratory work-up: elevated total IgE (519g/L), and eosinophilia (580/mm). Renal function tests were normal.
We concluded on a probable diagnosis of Kimura's disease in view of male gender, the head and neck site, the suggestive histological appearance, elevated IgE, and eosinophilia. However, this patient's age and ethnic origin were unusual for Kimura's disease. The main differential diagnosis is angiolymphoid hyperplasia with eosinophilia (ALHE) and renal function tests can distinguish between the two entities due to the kidney damage observed in Kimura's disease.
木村病是一种病因不明的罕见疾病，影响东南亚地区 30 多岁的男性。作者报告了 1 例 50 岁突尼斯男性木村病病例，该病例在手术后确诊。
该患者右下颌有两个 2cm 直径的慢性结节性病变，无局部炎症，也无全身性疾病的其他临床发现。组织病理学检查显示生发中心增生、嗜酸性微脓肿和小静脉后增生，提示为木村病，实验室检查结果证实了这一点：总 IgE 升高（519g/L）和嗜酸性粒细胞增多（580/mm）。肾功能检查正常。
鉴于该患者为男性，病变位于头颈部，组织学表现具有提示性，IgE 升高和嗜酸性粒细胞增多，我们得出了木村病的可能诊断。然而，该患者的年龄和种族起源与木村病不同。主要的鉴别诊断是血管淋巴样增生伴嗜酸性粒细胞增多症（ALHE），而肾功能检查可以区分这两种疾病，因为木村病会导致肾脏损伤。
