Yorita Kenji, Fujii Tatsuya, Nagao Toshitaka, Murakami Ichiro, Hashida Yumiko, Higuchi Tomonori, Daibata Masanori, Toi Makoto, Ayada Yoshiyuki, Igawa Takuro
Department of Diagnostic Pathology, Japanese Red Cross Kochi Hospital, 1-4-63-11, Hadaminami-machi, Kochi-shi, Kochi, 780-8562, Japan.
Department of Diagnostic Pathology, Kochi University Hospital, Kohasu, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan.
Radiol Case Rep. 2023 Mar 16;18(5):1933-1938. doi: 10.1016/j.radcr.2023.02.027. eCollection 2023 May.
A case of an asymptomatic 19-year-old woman with Kimura disease presenting with a nodule in the right parotid gland is presented. She had a medical history of atopic dermatitis and noticed a mass on her right-side neck. Cervical lymphadenopathy was clinically diagnosed. The initial management plan was to observe the lesion, which had enlarged from 1 cm to 2 cm in diameter 6 months later. An excisional biopsy was performed, and the pathology confirmed an eosinophil-containing inflammatory parotid gland lesion with many squamous nests and cysts, mimicking a parotid gland tumor. High serum immunoglobulin E levels, peripheral blood eosinophilia, and pathological and genetic diagnoses confirmed Kimura disease. The lesion tested negative for human polyomavirus 6. No recurrence was observed 15 months after the biopsy. The prognosis of Kimura disease without human polyomavirus 6 infection may be favorable; however, further validation of this hypothesis is required as only 5 or 6 cases of Kimura disease have been evaluated for this viral infection. Proliferative squamous metaplasia occurring in parotid gland lesions of Kimura disease is rare and may complicate the diagnostic imaging and pathological diagnosis.
本文报告一例19岁无症状女性木村病患者,其表现为右侧腮腺结节。她有特应性皮炎病史,发现右侧颈部有肿物,临床诊断为颈部淋巴结病。最初的治疗方案是观察该病变,6个月后其直径从1厘米增大至2厘米。遂进行切除活检,病理证实为含嗜酸性粒细胞的炎性腮腺病变,有许多鳞状巢和囊肿,类似腮腺肿瘤。高血清免疫球蛋白E水平、外周血嗜酸性粒细胞增多以及病理和基因诊断证实为木村病。该病变人多瘤病毒6检测呈阴性。活检后15个月未观察到复发。无人类多瘤病毒6感染的木村病预后可能良好;然而,由于仅对5或6例木村病患者进行了这种病毒感染评估,因此该假设需要进一步验证。木村病腮腺病变中发生的增生性鳞状化生罕见,可能会使诊断成像和病理诊断复杂化。