A pathological study on eosinophilic lymphfolliculoid granuloma (Kimura's disease).

The present study included 46 cases of eosinophilic lymphfolliculoid granuloma(kimura's disease), which occurred mainly in males between the ages of 11 to 52 years. The common sites were the soft tissue of the head and neck region. Although recurrence was not infrequent, the clinical course was benign. Laboratory findings revealed eosinophilia and frequent elevation of serum IgE. The histological characteristics consisted of proliferation of lymphoid follicles and granulation tissue with infiltration of eosinophils, mast cells, plasma cells, lymphocytes, and histiocytes, some degree of vascular proliferation, and fibrosis. With the appliance of unlabeled peroxidase-antiperoxidase method, a marked reticular reaction of IgE was confirmed in the germinal center of the folliculoid structure, and there were quite a number of IgE producing plasma cells. Many mast cells with IgE bound to their cell surface were seen in the granulation tissue. Toluidine blue staining and electron microscopy revealed fairly well preserved granules in mast cells, being quite different from the changes seen in type I allergy.