두경부 종물의 드문 원인인 Kimura씨 병

김재원,전용선,고국진,김경태,최정석,김영모 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.4

Background and Objectives:Kimura’s disease is a rare, allergic, inflammatory disorder of unknown cause. Patients oftenpresent nontender subcutaneous swelling in the head and neck region. Lymphadenopathy, peripheral eosinophilia, and anelevated serum IgE are also present. Kimuras disease is easily mistaken for malignant tumor, and has been confused withangiolymphoid hyperplasia with eosinophilia (ALHE). The diagnosis is confirmed by a biopsy. Treatment options range fromobservation to surgical excision, steroid therapy, and radiotherapy. We summarize characteristics of clinical feature, laboratoryresults in six cases of Kimuras disease and report the results of treatment, including surgery and steroid therapy. Subjects andMethod:Between May 1999 and August 2003, six cases were diagnosized as Kimura’s disease at the Department of OtorhinolaryngologyHead & Neck Surgery at the Inha University. Six cases included four males and two females, with the mean age of47.3 years. Preoperative evaluation included CT or MRI, CBC, and urine analysis. The study was done retrospectively. Result:Primary sites were two parotid glands, one submandibular gland, two neck lymph nodes, one scalp & cheek. Complete excisionwith steroid therapy was done in all cases. Five cases had peripheral eosinophilia. All cases reveal renal involvement,postsurgical complication or recurrence. Conclusion:Steroid therapy following surgical excision is the treatment of choice fordefinitive diagnosis and initial management. Kimuras disease must be included in the differential diagnosis of unusual head andneck mass because Kimuras disease is an unusual condition and it imitates the neoplastic or imflammatory condition in the headand neck.

이하선에 발생한 Kimura병 1례

이세빈,유원민,탁관철 대한두개안면성형외과학회 2007 Archives of Craniofacial Surgery Vol.8 No.1

Kimura disease is a relatively uncommon chronic inflammatory disorder of unknown etiology. Kimura disease occurs mainly in oriental young males. The majority of lesions occur in the head and neck and most patients have involvement of regional lymph nodes and major salivary glands. Although Kimura disease is similar to malignancy clinically and radiologically, it is benign disease showing good prognosis in only conservative management. So it is important to familiarize clinical, histological and radiological findings. We experienced a case of mass which developed on parotid gland of 40-year-old male. On impression of malignancy, total parotidectomy was performed. The Histological report was Kimura disease. There has been no recurrence during follow-up period of two years.

귀밑샘의 기무라병의 세침흡인 세포학적 소견 -세포학적 검사로 예측할 수 없었던 1예 보고-

김세훈,김혜령,김성은,양우익,이광길,홍순원,Kim, Se-Hoon,Kim, Hae-Ryoung,Kim, Sung-Eun,Yang, Woo-Ick,Lee, Kwang-Gil,Hong, Soon-Won 대한세포병리학회 2003 대한세포병리학회지 Vol.14 No.2

Kimura's disease is a chronic inflammatory disorder of unknown cause and is most prevalent among Asians. The cytologic findings of Kimura's disease are significant numbers of eosinophils in a background of lymphoid cells, occasional fragments of collagenous tissue, proliferation oi vessels, and Warthin-Finkeldey polykaryocytes. Among these features, the most important cytologic feature of Kimura's disease is a significant numbers of eosinophils. We experienced a case of Kimura's disease in the parotid gland which we fatted to recognize on cytology due to the apparent paucity of eosinophils. On careful retrograde reviewing of the cytologic findings, a few scattered leukocytes, previously interpreted as polymorphous leukocytes, had bilobed nuclei and coarse green but granular cytoplasm on Papanicolaou preparation. These leukocytes showed obvious orange-red intracyloplasmic granules as in eosionophils on Giemsa stain. The paucity of eosinophils may be due to the thick fibrosis around lymphoid follicles or any technical error during aspiration. Whereas the Warthin-Finkeldey type giant cell is not a sensitive cytologic marker of Kimura's disease, it may be a helpful cytologic feature. To reach a correct cytologic diagnosis of Kimura's disease, It is important to keep in mind that searching for Warthin-Finkeldey type giant cells and evaluation of Giemsa stain for detection of eosinophils would be helpful.

Kimura Disease 치험예보고 : 이하선 종양과의 감별 Pitfalls in Parotid Gland Surgery

류재현,정구용,한호성,최용만 梨花女子大學校 醫科大學 醫科學硏究所 1997 EMJ (Ewha medical journal) Vol.20 No.4

Kimura disease, which was initially described by Kimura et al. in 1948, is a rare entity that occurs primarily in Asian people characterized histopathologically by a lymphofolliculoid granuloma with infiltration of the mass and the surrounding tissue by eosinophils, often with concomitant peripheral blood eosinophilia and elevated serum Ig E. The kimura disease frequentlly involves head and neck region and reraly extrimities. When the disease involvews parotid gland, it is very difficult to differentiate clinically with parotid gland tumor. We have experienced a case of Kimura disease. The lesion was initially diagnosed as a parotid gland due to extensive fibrosis surrounding the mass. So, the mass excision was performed without clear identification of the facial nerve. The Kimura disease usually follows a benign course. But when this disease is confused with parotid gland tumor, there will be a danger of nerve injury due to difficulty in dissection of the extensive fibrotic soft tissue surrounding the parotid gland.

기무라 병 환자에서 수술적 치료 및 술후 스테로이드 병합요법의 치험 2례

김정태,김연환,김기웅,이경묵 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.2

Purpose: Kimura’s disease is a relatively rare head and neck tumor that frequently occurs in young orientals accompanied by eosinophila. We shared our experience of two cases of Kimura’s disease, treated by radical resection and post operative steroid therapy, so we report the correlation of eosinophil counts and disease progression. Methods: A 25 years old male came to the clinic with a mass localized to the right cheek inferior to the right auricle. We could not resect the mass totally. During the follow up period, we checked the eosinophil counts, and steroid therapy was started 7 months after the surgery. A 34 year old female came to the clinic with a mass localized inferior to the left auricle reaching from the posterior portion of the auricle to the left temporal portion. We tried to remove as much tumor as possible, save the temporal region, in regard to the impairment of blood supply to the auricle. After the operation, steroid therapy was started. Received January 4, 2009 Revised January 12, 2009 Accepted February 9, 2009 Address Correspondence: Jeong Tae Kim, M.D., Ph.D., Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, 17 Haengdang-dong, Seongdong-gu, Seoul 133-792, Korea. Tel: 02) 2290-8560/ Fax: 02)2293-6517/E-mail: jtkim@hanyang.ac.kr Results: In the first case, the tumor was easily approachable, and radical resection of the tumor with post operative steroid therapy was an effective treatment. In tumors located at difficult regions to remove, as in the second case, optimal debulking and post operative steroid therapy was also effective in treating Kimura’s. There were no recurrences in both cases. Eosinophil counts were always reduced after surgery and steroid therapy, and during the period with low eosinophil counts, there was no recurrence of Kimura’s disease. Conclusion: Surgery and post operative steroid therapy were effective in treatment of Kimura’s disease, and we could assume eosinophil counts as a good indicator for evaluation of the prognosis of Kimura’s disease during the follow up period

증례 : Kimura 병 경과관찰 중 발생한 NK/T 세포 림프종 1예

양기영 ( Ki Young Yang ),고성준 ( Seong Joon Koh ),김철우 ( Chul Woo Kim ),김인호 ( In Ho Kim ),윤성수 ( Sung Soo Yoon ),박선양 ( Seon Yang Park ),김병국 ( Byoung Kook Kim ) 대한내과학회 2007 대한내과학회지 Vol.73 No.6

본 증례는 Kimura 병으로 진단받은 후 경과관찰 중폐에 악성 림프종이 발생하였으며, 두 질환의 조직 모두에서 Epstein-Barr virus가 발견되었던 예로 이를 통해 두 질환 사이의 발병 기전의 연관 가능성을 시사하는 증례로서 국내외에 유사보고가 없는 것으로 생각되어 보고하는 바이다. Kimura`s disease is a rare chronic inflammatory disease of the lymphoid organs and this presents as painless nodules in the head and neck area. It occurs endemically in the Far East Asia and sporadically in the West. Its exact etiology is unknown and it has no potential to transform into malignant disease. However, it is often confused with malignant disease such as malignant lymphoma. We report a case of NK/T cell lymphoma patient who had Kimura`s disease in the right thigh 3 years ago. She then suffered from sudden dyspnea. Radiological studies revealed multiple small nodules scattered in both lung fields. NK/T cell lymphoma was diagnosed by open lung biopsy. In addition, Epstein-Barr virus (EBV) was detected in the previous site of Kimura`s disease and lung nodule by molecular pathologic examination. To the best of our knowledge, this is the first case of NK/T cell lymphoma complicating Kimura`s disease with coexisting chronic EBV infection.(Korean J Med 73:656-660, 2007)

기무라씨병에 속발한 위장관 임프종 1례

최찬옥,정준,변흥렬,이승은,라성찬,서영돈,김계혁,김영진,박영회 大韓血液學會 1993 大韓血液學會誌 Vol.28 No.1

A clinicopathological study of Kimura's disease and epithelioid hemangioma

Ahn, Hee Jeong,Lee, Kwang-Gil Yonsei University, College of Medicine 1990 Yonsei medical journal Vol.31 No.3

Kimura 병에 병발한 신증후군 2례

한혜원,박경미,하일수,최용,정해일,Hahn Hye-Won,Park Kyung-Mi,Ha Il-Soo,Choi Yong,Cheong Hae-Il 대한소아신장학회 1999 Childhood kidney diseases Vol.3 No.2

Kimura disease is a chronic benign disorder, primarily seen in asians male during the second and third decades of life, which presents itself as a tumour like lesion with a predilection for the head and neck region. There is high prevalence of associated renal disease. We report two cases of nephrotic syndrome associated with Kimura disease, and this is the first report of Kimura disease with renal involvement in Korean children.

기무라병에서 발생한 급성 뇌경색증, 깊은정맥혈전증, 폐색전증

강현구,김수성,조재훈,박형종,정진성,하연수,이학승,박현영,장혁,조광호 대한뇌졸중학회 2011 Journal of stroke Vol.13 No.2

Kimura’s disease is a chronic infl ammatory disease producing subcutaneous tumor-like nodules chiefl y in the head and neck region. It is characterized histologically by lymphoid follicles, intense aggregations of eosinophils, vascular proliferation and fi -brosis combined with peripheral blood eosinophilia. We report a 56-year-old man who presented with dysarthria and right hemiparesis. On physical examination, a non-ender mass 5 × 6 cm was identifi ed in the right submandibular area. He was diagnosed with Kimura’s disease by biopsy. One month after admission, he complained of paresthesia in the left lower extremity. CT angiography revealed thromobosis in the left femoral vein and bilateral pulmonary embolism. To our knowledge, the concomitant occurrence of acute cerebral infarction, deep vein thrombosis and pulmonary embolism in patients with Kimura’s disease has never been reported. Eosinophil-derived cytotoxic proteins are presumed to be fundamental to the pathogenesis of these disorders in Kimura’s disease. (Korean J Stroke 2011;13:85-88)