Chow L T, Yuen R W, Tsui W M, Ma T K, Chow W H, Chan S K
Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Hong Kong.
Am J Clin Pathol. 1994 Sep;102(3):316-21. doi: 10.1093/ajcp/102.3.316.
Kimura's disease is a chronic inflammatory disorder of unknown etiology, presenting usually as painless subcutaneous swellings in the head and neck region or in the salivary glands. The cytologic features of fine-needle aspirates of eight cases of Kimura's disease were studied with reference to the histologic appearance of the subsequent surgical specimens. In the cytologic smears, the prominent feature was the presence of significant numbers of eosinophils in a background of lymphoid cells. Fragments of collagenous tissue and Warthin-Finkeldey polykaryocytes occasionally were seen. In the cell block, vascular proliferation and fibrosis were useful features, providing further support to the diagnosis. The constellation of these features is characteristic of Kimura's disease and should suggest this diagnosis in the appropriate clinical setting. For initial diagnosis, excisional biopsy is important for the exclusion of malignant lymphoma, histiocytosis X, angiolymphoid hyperplasia with eosinophilia and other reactive lymphadenopathies. Nonetheless, fine-needle aspiration cytology may be valuable in the diagnosis of recurrent lesions of Kimura's disease and may spare the patient from repeated biopsies.
木村病是一种病因不明的慢性炎症性疾病,通常表现为头颈部或唾液腺无痛性皮下肿物。参照后续手术标本的组织学表现,对8例木村病细针穿刺抽吸物的细胞学特征进行了研究。在细胞学涂片上,突出特征是在淋巴细胞背景中存在大量嗜酸性粒细胞。偶尔可见胶原组织碎片和华通-芬克德多核巨细胞。在细胞块中,血管增生和纤维化是有用的特征,为诊断提供了进一步支持。这些特征的组合是木村病的特点,在适当的临床情况下应提示该诊断。对于初步诊断,切除活检对于排除恶性淋巴瘤、组织细胞增多症X、嗜酸性粒细胞增多性血管淋巴样增生及其他反应性淋巴结病很重要。尽管如此,细针穿刺细胞学检查在木村病复发病变的诊断中可能有价值,且可使患者免于重复活检。