金伯氏病在骨科行广泛切除治疗：两例报告。
Kimura's Disease Diagnosed in the Department of Orthopedic Surgery Treated With Wide Excision: Report of Two Cases.
机构信息
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan;
出版信息
In Vivo. 2023 May-Jun;37(3):1373-1378. doi: 10.21873/invivo.13219.
BACKGROUND/AIM: Kimura's disease is a rare chronic inflammatory disorder that commonly affects the head and neck regions, occurring predominantly in Asian men. Elevated eosinophil count and IgE levels in the peripheral blood examination are suggestive of this disease. In this study we report two cases of Kimura's disease, treated with wide excision.
CASE REPORT
The first case was a 58-year-old man presented with asymptomatic left neck mass. The second case was a 69-year-old man with swelling of the right upper arm, which was suggestive of soft tissue mass. Needle biopsy results were suggestive of Kimura's disease in both cases. Elevated WBCs at 8,380/μl (neutrophils: 45%, eosinophils: 33%) for the first case and 5,370/μl (neutrophils: 61.8%, eosinophils: 3.5%) for the second one, and serum IgE at 14.988 IU/ml for the first case and 1,315 IU/ml for the second one were observ. For definitive treatment and diagnosis, wide excisions were performed. Final histopathological results revealed Kimura's disease. Surgical margins were negative even though an ill-demarcated lesion for the first case and high infiltration to the muscle for second case were confirmed.
CONCLUSION
Wide excision was performed in both cases of Kimura's disease and no recurrence was observed until the final follow-up. Wide excision with negative surgical margin should be recommended for the treatment of Kimura's disease.
背景/目的：木村病是一种罕见的慢性炎症性疾病，通常影响头颈部，主要发生在亚洲男性中。外周血检查中嗜酸性粒细胞计数和 IgE 水平升高提示该病。本研究报告了两例经广泛切除治疗的木村病病例。
病例报告
第一例为 58 岁男性，表现为无症状性左侧颈部肿块。第二例为 69 岁男性，右上臂肿胀，提示软组织肿块。两例的针吸活检结果均提示为木村病。第一例的白细胞计数为 8380/μl（中性粒细胞：45%，嗜酸性粒细胞：33%），第二例为 5370/μl（中性粒细胞：61.8%，嗜酸性粒细胞：3.5%），第一例的血清 IgE 为 14.988 IU/ml，第二例为 1315 IU/ml。为明确诊断和治疗，进行了广泛切除。最终的组织病理学结果显示为木村病。尽管第一例病变边界不清，第二例浸润至肌肉，但手术切缘均为阴性。
结论
两例木村病均行广泛切除术，随访至最后未见复发。对于木村病的治疗，应推荐行广泛切除术并保证切缘阴性。
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