PubMed · 14606173
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Hong Chen, Lester D Thompson. 2003. Kimura disease.. https://pubmed.ncbi.nlm.nih.gov/14606173/
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Kimura disease (KD) is a rare, benign, chronic inflammatory disorder most often found in young Asian males that can simulate a neoplasm. We report a case of renal cell carcinoma and KD within the same kidney. To our knowledge, this is the first reported case of KD involving the kidney confirmed pathologically, as well as the first association of KD with renal cell carcinoma.
Kimura disease is a rare but distinctive chronic eosinophilic inflammatory disorder that is characterized by tumor-like lesions in the soft tissue and lymph nodes of the head and neck or parotid gland. Recently, many immunopathogenetic features of underlying T lymphocytes and related cytokines have been noted in Kimura disease. However, few previous studies have investigated the serial levels of cytokines in children. In this report we describe an 11-year-old Japanese boy with relapsing Kimura disease. Before the diagnosis of Kimura disease, the patient had a swelling on his left neck. Steroids were effective, but the tumor relapsed within a few months as the steroids were tapered. He was treated with steroids and cyclosporine. This treatment was done by measuring serial levels of serum soluble interleukin-2 receptor, interleukin-4, interleukin-5, and eosinophil cationic protein. These results suggest the activation of T-helper cells and T-helper 2 cytokines, that after activated B cells and eosinophilic infiltration play an important role in Kimura disease, and that cyclosporine suppresses the activity of this disease.
Kimura's disease is a chronic inflammatory disorder that occurs mainly in Asian patients. Most imaging studies focus on the loco-regional involvement of this disorder. Images of the whole body fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) scan have not been reported in the literature before. The possibility of lymphoid clonality is also discussed frequently despite its clinically benign course. We present a patient of Kimura's disease initially assessed by whole body 18F-FDG PET study and proved by pathologic findings. 18F-FDG-PET scan showed diffusely intense uptake in the neck, axillary, pelvic and inguinal nodal regions bilaterally, as well as in the mediastinal, celiac region. The flow cytometric analysis of lymph node tissue confirmed the absence of clonality. The image of 18F-FDG-PET in Kimura's disease can closely resemble that seen in neoplastic disorders such as lymphoma or metastatic lymphadenopathy. It should be taken into consideration as a differential diagnosis for a generalized lymphadenopathy.