A rare case report of Kimura's Disease

Abstract

Kimura's Disease is an extremely rare disease. A retrospective review of only 21 histopathologic specimens have been done at the US armed forces Institute of Pathology           diagnosed as Kimura's Disease, which found the following racial distributions of 7 whites, 6 African American ,6 Asian,1 Hispanic and 1 Arab. Here we present a case of Kimura's Disease in our hospital. A 29 years old female, non smoker with complaints of multiple swellings in the right side of the neck associated with pain and difficulty in swallowing since past 1 year with no history of systemic symptoms (fever, night sweats, weight loss) which did not resolve with routine antibiotics and antitubercular drugs. Her routine blood counts were normal and her renal and liver function tests were also normal. Her Ultrasound neck revealed multiple heteroechoic nodes of varying size noted in right level II, III and IV lymph nodes (largest of size measuring 1.5x2.3 cm). A well defined collection noted in right side of neck               measuring 3.8x2.1cm, features suggestive of abscess. CT Neck showing multiple well defined nodular heterogeneously                 enhancing masses in right side of the neck, largest measuring 3.5x2.8 cm in diameter suggestive of right cervical                     lymphadenopathy of level II, III and IV lymph nodes of neck. Her x ray chest, sputum AFB and sputum culture sensitivity were negative for tuberculosis. A FNAC an d biopsy was done. FNAC of her right cervical lymph node showed moderately cellular smear representing scattered lymph node, plasma cells, histiocytes and occasional atypical cells in a haemorrhagic background. Excision Biopsy of her right cervical lymph node showed nodules with peripheral lymphoid tissue and adjoining fibrocollagenous stroma , densely infiltrated by sheets of eosinophils admixed with lymphocytes, proliferating capillaries, plump histiocytosis and intervening areas of hyalinization,    features suggestive of Kimura's Disease. This case is presented for its rarity